Provider Demographics
NPI:1871042077
Name:U.S. HEALTHWORKS MEDICAL GROUP OF INDIANA, PC
Entity type:Organization
Organization Name:U.S. HEALTHWORKS MEDICAL GROUP OF INDIANA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:T
Authorized Official - Last Name:MALLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-678-2600
Mailing Address - Street 1:25124 SPRINGFIELD CT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1085
Mailing Address - Country:US
Mailing Address - Phone:661-678-2600
Mailing Address - Fax:661-678-2700
Practice Address - Street 1:4125 WEST CLARA LANE
Practice Address - Street 2:SUITE 200
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-5412
Practice Address - Country:US
Practice Address - Phone:765-288-8800
Practice Address - Fax:765-751-2278
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:U.S HEALTHWORKS MEDICAL GROUP OF INDIANA, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty