Healthcare Provider Details

I. General information

NPI: 1730354317
Provider Name (Legal Business Name): NORMAN N GE, MD, A PROFESSIONAL MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2008
Last Update Date: 04/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16300 SAND CANYON AVE SUITE 201
IRVINE CA
92618-3711
US

IV. Provider business mailing address

16300 SAND CANYON AVE SUITE 201
IRVINE CA
92618-3711
US

V. Phone/Fax

Practice location:
  • Phone: 949-727-1818
  • Fax: 949-727-1819
Mailing address:
  • Phone: 949-727-1818
  • Fax: 949-727-1819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberA069762
License Number StateCA

VIII. Authorized Official

Name: DR. NORMAN N GE
Title or Position: PRESIDENT
Credential: MD
Phone: 949-727-1818