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NPI Code Detail

MEDICARE: DR. PATRICIA ANN AHEARN M.D.

MEDICARE: DR. PATRICIA ANN AHEARN M.D.
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
1174400000XSpecialistG54979CA
2207R00000XInternal Medicine PhysicianG54979CA

General Provider Information

NPI Number : 1982655304
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATRICIA ANN AHEARN M.D.
Provider Business Mailing Address
First Line : PO BOX 7087
Second Line :
City : ORANGE
State : CA
Zip : 92863-7087
Country : US
Telephone Number : 714-571-5000
Fax Number : 714-571-5055
Provider Business Practice Location Address
First Line : 30230 RANCHO VIEJO RD
Second Line : SUITE 200
City : SAN JUAN CAPISTRANO
State : CA
Zip : 92675-1557
Country : US
Telephone Number : 949-443-4303
Fax Number : 949-443-4033
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 04/16/2013

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