Dr Jonathan Mark Wada, MD | |
14642 Newport Ave Ste 200, Tustin, CA 92780-6058 | |
(714) 247-0300 | |
(714) 259-1598 |
Full Name | Dr Jonathan Mark Wada |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 14642 Newport Ave Ste 200, Tustin, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780995068 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 2010018037 (Missouri) | Secondary |
207Q00000X | Family Medicine | A121522 (California) | Primary |
Entity Name | Hurtt Family Health Clinic Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306965587 PECOS PAC ID: 4183764814 Enrollment ID: O20110203000426 |
Mailing Address | Practice Location Address |
---|---|
Dr Jonathan Mark Wada, MD 14642 Newport Ave Ste 300, Tustin, CA 92780-6059 Ph: (714) 247-0300 | Dr Jonathan Mark Wada, MD 14642 Newport Ave Ste 200, Tustin, CA 92780-6058 Ph: (714) 247-0300 |
Renee Heather Ballentine, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1451 Irvine Blvd, Tustin, CA 92780 Phone: 714-838-8878 | |
Dr. Stephen Chang, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1451 Irvine Blvd, Tustin, CA 92780 Phone: 714-838-8878 | |
Dr. Myron Reiff, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 3002 Dow Ave, Suite 204, Tustin, CA 92780 Phone: 714-368-0800 Fax: 714-368-0900 | |
Cathrin Hee Lim, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1 Hope Dr, Tustin, CA 92782 Phone: 714-247-0300 | |
Son Do, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 661 W 1st St Ste G, Tustin, CA 92780 Phone: 714-665-9890 Fax: 714-665-9891 | |
William Robert Crumpton, M,D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 14642 Newport Ave, Suite#200, Tustin, CA 92780 Phone: 714-669-4466 Fax: 714-669-4088 | |
Charles Chol Bae Kim, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 14642 Newport Ave Ste 105, Tustin, CA 92780 Phone: 714-831-1112 Fax: 714-486-2309 |