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NPI Code Detail

MEDICARE: DR. ANDREW JEFFERY MOCK MD, MPH

MEDICARE: DR. ANDREW JEFFERY MOCK MD, MPH
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
1207Q00000XFamily Medicine PhysicianA163587CA
22083P0901XPublic Health & General Preventive Medicine PhysicianA163587CA

General Provider Information

NPI Number : 1982101762
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW JEFFERY MOCK MD, MPH
Provider Business Mailing Address
First Line : 5190 CAMPUS DR
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92660-2101
Country : US
Telephone Number : 949-557-0951
Fax Number : 949-557-0952
Provider Business Practice Location Address
First Line : 4699 JAMBOREE RD
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92660-2526
Country : US
Telephone Number : 949-557-0951
Fax Number : 949-557-0952
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2018
Last Update Date : 06/25/2026

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