| Theodore Vandam M.d. | |
|
665 Camino De Los Mares Ste 210 San Clemente CA 92673-2859 | |
| (949) 240-6772 | |
| (949) 240-6841 |
| Full Name | Theodore Vandam M.d. |
|---|---|
| Speciality | Internal Medicine |
| Location | 665 Camino De Los Mares, San Clemente, California |
| Authorized Official Name and Position | Theodore Vandam (PRESIDENT) |
| Authorized Official Contact | 9492406772 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Theodore Vandam M.d. 665 Camino De Los Mares Ste 210 San Clemente CA 92673-2859 Ph: (949) 240-6772 | Theodore Vandam M.d. 665 Camino De Los Mares Ste 210 San Clemente CA 92673-2859 Ph: (949) 240-6772 |
| NPI Number | 1699978304 |
|---|---|
| Provider Enumeration Date | 06/08/2007 |
| Last Update Date | 07/28/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699978304 | NPI | - | NPPES |
| 00A247880 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A24788 (California) | Primary |
Care Gastroenterology Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 655 Camino De Los Mares, Sute 123, San Clemente, CA 92673 Phone: 949-443-1546 Fax: 949-443-1077 | |
San Clemente Internal Medical Group Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 665 Camino De Los Mares Ste 309, San Clemente, CA 92673 Phone: 949-487-9034 Fax: 949-493-3721 | |
Joomo Yang, Md., Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2403 Camino Corso Rio, San Clemente, CA 92673 Phone: 949-226-8416 Fax: 949-226-8019 | |