| Consortio Healthcare, Inc | |
|
12791 Newport Ave Suite 201 Tustin CA 92780-8023 | |
| (714) 505-0800 | |
| (714) 505-0139 |
| Full Name | Consortio Healthcare, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 12791 Newport Ave, Tustin, California |
| Authorized Official Name and Position | Kimberly Lyn Motta (PRESIDENT/OWNER) |
| Authorized Official Contact | 7145050800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Consortio Healthcare, Inc 12791 Newport Ave Suite 201 Tustin CA 92780-8023 Ph: (714) 505-0800 | Consortio Healthcare, Inc 12791 Newport Ave Suite 201 Tustin CA 92780-8023 Ph: (714) 505-0800 |
| NPI Number | 1790019370 |
|---|---|
| Provider Enumeration Date | 09/29/2009 |
| Last Update Date | 09/29/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790019370 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A65953 (California) | Primary |
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