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23962 Alicia Pkwy Ste I-1 Mission Viejo CA 92691-3940 | |
| (949) 452-7699 | |
| (949) 770-2815 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 23962 Alicia Pkwy Ste I-1, Mission Viejo, California |
| Authorized Official Name and Position | Theophile G. Koury (PRESIDENT) |
| Authorized Official Contact | 5103502842 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1601 Cummins Dr Ste D Modesto CA 95358-6411 Ph: (510) 350-2842 | 23962 Alicia Pkwy Ste I-1 Mission Viejo CA 92691-3940 Ph: (949) 452-7699 |
| NPI Number | 1598394686 |
|---|---|
| Provider Enumeration Date | 04/02/2020 |
| Last Update Date | 06/06/2021 |
| Medicare PECOS PAC ID | 8022433085 |
|---|---|
| Medicare Enrollment ID | O20200807000845 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598394686 | NPI | - | NPPES |
| Provider Name | Donald Rose |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1619992823 PECOS PAC ID: 3173574597 Enrollment ID: I20050202001098 |
| Provider Name | Sadeeq K Sadiq |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881642205 PECOS PAC ID: 0446274005 Enrollment ID: I20060323000810 |
| Provider Name | James N Goldberg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326250929 PECOS PAC ID: 3678660636 Enrollment ID: I20071107000645 |
| Provider Name | Aaron T Breit |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528271046 PECOS PAC ID: 6709962657 Enrollment ID: I20080318000742 |
| Provider Name | Faith Renee Lehman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518209444 PECOS PAC ID: 2769617927 Enrollment ID: I20140131000373 |
| Provider Name | Catherine Jean Caputo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528326824 PECOS PAC ID: 2567691405 Enrollment ID: I20140218001831 |
| Provider Name | Taylor S Nichols |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619249034 PECOS PAC ID: 0749588861 Enrollment ID: I20160406000126 |
Theodore J. Caliendo, M.d., A Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 27800 Medical Center Rd, Suite 204, Mission Viejo, CA 92691 Phone: 949-364-3691 Fax: 949-347-7645 | |
Rexinger Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 27800 Medical Center Rd, Suite 461, Mission Viejo, CA 92691 Phone: 949-364-5600 Fax: 949-364-2231 | |
Raef M Elsanadi Md Inc A Professional Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 27800 Medical Ctr Rd, 212, Mission Viejo, CA 92691 Phone: 949-364-3582 Fax: 949-364-3582 | |
Bristol Park Medical Group, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 26991 Crown Valley Pkwy, Mission Viejo, CA 92691 Phone: 949-582-2002 Fax: 949-367-5200 | |
South County Gastro Medical Clinic Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 26691 Plaza Ste 150, Mission Viejo, CA 92691 Phone: 949-348-2900 | |
California Emergency Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 23962 Alicia Pkwy, Ste 1, Mission Viejo, CA 92691 Phone: 949-452-7699 | |
J. Margo Jaffe Orr, M.d., Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 27725 Santa Margarita Pkwy, Suite 220, Mission Viejo, CA 92691 Phone: 949-305-9950 Fax: 949-305-9988 |