Healthcare Provider Details

I. General information

NPI: 1285892109
Provider Name (Legal Business Name): CLAUDIA EPPELE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DR. CLAUDIA GONZALEZ-RUIZ

II. Dates (important events)

Enumeration Date: 05/28/2008
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 BRISTOL ST STE B205
COSTA MESA CA
92626-5948
US

IV. Provider business mailing address

2900 BRISTOL ST STE B205
COSTA MESA CA
92626-5948
US

V. Phone/Fax

Practice location:
  • Phone: 855-867-5551
  • Fax: 855-867-5551
Mailing address:
  • Phone: 855-867-5551
  • Fax: 855-867-5551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberA51933
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA110633
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: