| Guardian Physician Oversight Inc. | |
|
5100 Colony Plz Newport Beach CA 92660-6347 | |
| (310) 953-9759 | |
| Not Available |
| Full Name | Guardian Physician Oversight Inc. |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 5100 Colony Plz, Newport Beach, California |
| Authorized Official Name and Position | Thomas Dosumu Johnson (OWNER) |
| Authorized Official Contact | 3109539759 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Guardian Physician Oversight Inc. 324 S Beverly Dr # 214 Beverly Hills CA 90212-4801 Ph: (310) 953-9759 | Guardian Physician Oversight Inc. 5100 Colony Plz Newport Beach CA 92660-6347 Ph: (310) 953-9759 |
| NPI Number | 1427710763 |
|---|---|
| Provider Enumeration Date | 10/13/2021 |
| Last Update Date | 10/13/2021 |
| Certification Date | 10/13/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427710763 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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