Healthcare Provider Details

I. General information

NPI: 1720381015
Provider Name (Legal Business Name): RICK F POSPISIL MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2010
Last Update Date: 01/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18800 DELAWARE ST. STE 700
HUNTINGTON BEACH CA
92648-6018
US

IV. Provider business mailing address

18800 DELAWARE ST. STE 700
HUNTINGTON BEACH CA
92648-6018
US

V. Phone/Fax

Practice location:
  • Phone: 714-848-8125
  • Fax: 714-848-9030
Mailing address:
  • Phone: 714-848-8125
  • Fax: 714-848-9030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberG39717
License Number StateCA

VIII. Authorized Official

Name: DR. RICK F. POSPISIL
Title or Position: OWNER
Credential: MD
Phone: 714-848-8125