Healthcare Provider Details

I. General information

NPI: 1174843122
Provider Name (Legal Business Name): IPAPC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2010
Last Update Date: 06/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 E IMPERIAL HWY SUITE 202
BREA CA
92821-6103
US

IV. Provider business mailing address

2650 E IMPERIAL HWY SUITE 202
BREA CA
92821-6103
US

V. Phone/Fax

Practice location:
  • Phone: 714-524-3054
  • Fax: 714-524-3094
Mailing address:
  • Phone: 714-524-3054
  • Fax: 714-524-3094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM J CHRISTIE
Title or Position: OWNER
Credential: M.D.
Phone: 714-524-3054