N Jauregui Professional Medical Corporation | |
10061 Talbert Ave Ste 200 Fountain Valley CA 92708-5123 | |
(877) 830-7328 | |
Not Available |
Full Name | N Jauregui Professional Medical Corporation |
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Speciality | Clinic/Center |
Location | 10061 Talbert Ave Ste 200, Fountain Valley, California |
Authorized Official Name and Position | Katrina Ling (ADMINISTRATOR) |
Authorized Official Contact | 3104804556 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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N Jauregui Professional Medical Corporation 10061 Talbert Ave Ste 200 Fountain Valley CA 92708-5123 Ph: (877) 830-7328 | N Jauregui Professional Medical Corporation 10061 Talbert Ave Ste 200 Fountain Valley CA 92708-5123 Ph: (877) 830-7328 |
NPI Number | 1164099792 |
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Provider Enumeration Date | 06/10/2021 |
Last Update Date | 06/10/2021 |
Medicare PECOS PAC ID | 9032514344 |
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Medicare Enrollment ID | O20210825001808 |
Identifier | Type | State | Issuer |
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1164099792 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
Provider Name | Nicholas J Jauregui |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1205869807 PECOS PAC ID: 7315995115 Enrollment ID: I20050107000930 |
Provider Name | Jae Lee |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1912105297 PECOS PAC ID: 1355513326 Enrollment ID: I20111017000706 |
Provider Name | Edward Meltser |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1124536289 PECOS PAC ID: 7618226812 Enrollment ID: I20180821004170 |
Provider Name | Annie Mali Hadfield |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265041651 PECOS PAC ID: 7911318365 Enrollment ID: I20201116002884 |
Provider Name | Kenneth Saldua |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730728742 PECOS PAC ID: 6002228657 Enrollment ID: I20210118000564 |
Provider Name | Christopher Michael Phillips |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1629698733 PECOS PAC ID: 6901251636 Enrollment ID: I20231016001083 |
Provider Name | Connie Love |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407495351 PECOS PAC ID: 9638525165 Enrollment ID: I20231019002179 |
Provider Name | Jennilyn Tuazon Raynor |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598356024 PECOS PAC ID: 0941646939 Enrollment ID: I20240313000636 |
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