Healthcare Provider Details

I. General information

NPI: 1659580744
Provider Name (Legal Business Name): SPECTRUM INTERNAL MEDICINE ASSOCIATES, INC. A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4870 BARRANCA PKWY SUITE 250
IRVINE CA
92604-4709
US

IV. Provider business mailing address

PO BOX 60099
IRVINE CA
92602-6003
US

V. Phone/Fax

Practice location:
  • Phone: 949-272-3800
  • Fax: 949-262-0089
Mailing address:
  • Phone: 949-272-3800
  • Fax: 949-262-0089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JULIE KUNIYOSHI
Title or Position: MD
Credential: MD
Phone: 949-272-3800