| |
26841 Calle Hermosa, Suite A, Capistrano Beach, CA 92624-1674 | |
(949) 488-9600 | |
(949) 488-9601 |
Full Name | |
---|---|
Type | Facility |
Speciality | Family Medicine |
Location | 26841 Calle Hermosa, Capistrano Beach, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568736304 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111NS0005X | Chiropractor - Sports Physician | (* (Not Available)) | Secondary |
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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26841 Calle Hermosa, Suite A, Capistrano Beach, CA 92624-1674 Ph: (949) 488-9600 | 26841 Calle Hermosa, Suite A, Capistrano Beach, CA 92624-1674 Ph: (949) 488-9600 |