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NPI Code Detail

MEDICARE: MR. DORIAN POLANCO II

MEDICARE: MR. DORIAN POLANCO II
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation PractitionerCA
2373H00000XDay Training/Habilitation SpecialistCA

General Provider Information

NPI Number : 1588429856
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DORIAN POLANCO II
Provider Business Mailing Address
First Line : 25402 PACIFICA AVE
Second Line :
City : MISSION VIEJO
State : CA
Zip : 92691-3854
Country : US
Telephone Number : 949-238-2400
Fax Number :
Provider Business Practice Location Address
First Line : 25402 PACIFICA AVE
Second Line :
City : MISSION VIEJO
State : CA
Zip : 92691-3854
Country : US
Telephone Number : 949-238-2400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2024
Last Update Date : 01/28/2026

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