| Fred Galluccio Md & Assoc Inc | |
|
901 Dover Dr Ste 102 Newport Beach CA 92660-5538 | |
| (949) 646-4865 | |
| (949) 646-7716 |
| Full Name | Fred Galluccio Md & Assoc Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 901 Dover Dr, Newport Beach, California |
| Authorized Official Name and Position | Fred J Galluccio (OWNER) |
| Authorized Official Contact | 9496464865 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fred Galluccio Md & Assoc Inc 901 Dover Dr Ste 102 Newport Beach CA 92660-5538 Ph: (949) 646-4865 | Fred Galluccio Md & Assoc Inc 901 Dover Dr Ste 102 Newport Beach CA 92660-5538 Ph: (949) 646-4865 |
| NPI Number | 1437267648 |
|---|---|
| Provider Enumeration Date | 08/28/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0941482822 |
|---|---|
| Medicare Enrollment ID | O20110314000892 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437267648 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Paul M Eisman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285639773 PECOS PAC ID: 4385691591 Enrollment ID: I20050331000163 |
| Provider Name | Fred Galluccio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104934397 PECOS PAC ID: 6507759008 Enrollment ID: I20110314000557 |
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