Healthcare Provider Details

I. General information

NPI: 1861074353
Provider Name (Legal Business Name): MUNOZ FAMILY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2021
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1741 W ROMNEYA DR STE A
ANAHEIM CA
92801-1805
US

IV. Provider business mailing address

PO BOX 18733
ANAHEIM CA
92817-8733
US

V. Phone/Fax

Practice location:
  • Phone: 714-491-7500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARIA MUNOZ
Title or Position: OWNER/OFFICE MANAGER
Credential:
Phone: 714-491-7500