| Pediatric Subspecialty Faculty | |
|
455 S Main St Orange CA 92868-3835 | |
| (714) 516-4295 | |
| Not Available |
| Full Name | Pediatric Subspecialty Faculty |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology |
| Location | 455 S Main St, Orange, California |
| Authorized Official Name and Position | Elizabeth Farace (BILLING MANAGER) |
| Authorized Official Contact | 7144164295 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Subspecialty Faculty 455 S Main St Orange CA 92868-3835 Ph: (714) 516-4295 | Pediatric Subspecialty Faculty 455 S Main St Orange CA 92868-3835 Ph: (714) 516-4295 |
| NPI Number | 1427216316 |
|---|---|
| Provider Enumeration Date | 05/28/2008 |
| Last Update Date | 05/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427216316 | NPI | - | NPPES |
| GR009039E | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0402X | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology | (* (Not Available)) | Primary |
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