| Longevity Healthcare, Inc., A Medical Corporation | |
|
1601 Dove St Ste 170 Newport Beach CA 92660-1421 | |
| (805) 704-5705 | |
| Not Available |
| Full Name | Longevity Healthcare, Inc., A Medical Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 1601 Dove St Ste 170, Newport Beach, California |
| Authorized Official Name and Position | Peter John Muran (PRESIDENT) |
| Authorized Official Contact | 8883154777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Longevity Healthcare, Inc., A Medical Corporation 1024 Bayside Dr Ste 212 Newport Beach CA 92660-7462 Ph: (805) 704-5705 | Longevity Healthcare, Inc., A Medical Corporation 1601 Dove St Ste 170 Newport Beach CA 92660-1421 Ph: (805) 704-5705 |
| NPI Number | 1770096547 |
|---|---|
| Provider Enumeration Date | 11/14/2017 |
| Last Update Date | 07/23/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770096547 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261QM2500X | Clinic/center - Medical Specialty | (California) | Secondary |
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