Healthcare Provider Details

I. General information

NPI: 1598770950
Provider Name (Legal Business Name): DONALD I. ALTMAN MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 05/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16300 SAND CANYON AVE SUITE 1011
IRVINE CA
92618-3711
US

IV. Provider business mailing address

16300 SAND CANYON AVE SUITE 1011
IRVINE CA
92618-3711
US

V. Phone/Fax

Practice location:
  • Phone: 949-727-3999
  • Fax: 949-727-9053
Mailing address:
  • Phone: 949-727-3999
  • Fax: 949-727-9053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: DONALD I ALTMAN
Title or Position: OWNER
Credential: MD
Phone: 949-727-3999