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3151 Airway Ave Ste J2 Costa Mesa CA 92626-4624 | |
| (949) 355-3962 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 3151 Airway Ave Ste J2, Costa Mesa, California |
| Authorized Official Name and Position | Kate Livingood (PRESIDENT) |
| Authorized Official Contact | 9493553962 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3151 Airway Ave Ste J2 Costa Mesa CA 92626-4624 Ph: (949) 355-3962 | 3151 Airway Ave Ste J2 Costa Mesa CA 92626-4624 Ph: (949) 355-3962 |
| NPI Number | 1326506460 |
|---|---|
| Provider Enumeration Date | 03/07/2019 |
| Last Update Date | 02/13/2023 |
| Certification Date | 02/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326506460 | NPI | - | NPPES |
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