1013231893 NPI number — CALIFORNIA PHYSICIAN CONSULTANTS, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013231893 NPI number — CALIFORNIA PHYSICIAN CONSULTANTS, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CALIFORNIA PHYSICIAN CONSULTANTS, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013231893
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/15/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
DEPT 5043
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90084-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-470-3700
Provider Business Mailing Address Fax Number:
330-497-7940

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26730 CROWN VALLEY PKWY
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
MISSION VIEJO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92691-6364
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-505-2888
Provider Business Practice Location Address Fax Number:
949-364-2110
Provider Enumeration Date:
03/23/2010

Additional Information

Authorized Official

Authorized Official Last Name:
REID
Authorized Official First Name:
E.
Authorized Official Middle Name:
PAUL
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
408-347-4051

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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