CROSSOVER HEALTH MEDICAL GROUP
Ambulatory Health at Aliso Creek Rd, Laguna Beach, CA

License number
California A74386
Category
Ambulatory Health
Type
Primary Care
Owner
Name: DR. SCOTT LYMAN SHREEVE M.D.
Title: CHIEF EXECUTIVE OFFICER
Phone: (949) 235-9375
Address
Address 2
26831 Aliso Creek Rd SUITE 200, Laguna Beach, CA 92656
101 W. Avenida Vista Hermosa SUITE 120, San Clemente, CA 92672
National Provider ID: 1679702013
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about CROSSOVER HEALTH MEDICAL GROUP at bizstanding.com

CROSSOVER HEALTH MEDICAL GROUP, APC

Laguna Beach, CA  -  San Juan Capistrano, CA

Industry:
Health/Allied Services
Doing business as:
Crossover Health Medical Group, Apc
Registration:
Jun 4, 2012
Addresses:
65 Enterprise, Aliso Viejo, CA 92656 (Mailing)
27101 Puerta Real, San Juan Capistrano, CA 92691
26831 Aliso Crk Rd, Laguna Beach, CA 92656
State ID:
0801606798
Business type:
Foreign Professional Corporation
Directors:
Jeff Crichton (CONTROLLER, Controller), 65 Enterprise, Aliso Viejo, CA 92656,Scott Shreeve (President),Richard Patragnoni Director, inactive
Agent:
Northwest Registered Agent Llc,700 Lavaca, Austin, TX 78701 (Physical)
TIN:
32048151040

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