Healthcare Provider Details

I. General information

NPI: 1003993353
Provider Name (Legal Business Name): REBECCA ALLISON GARFINKLE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 03/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30131 TOWN CENTER DR STE 245
LAGUNA NIGUEL CA
92677-2033
US

IV. Provider business mailing address

30131 TOWN CENTER DR STE 245
LAGUNA NIGUEL CA
92677-2033
US

V. Phone/Fax

Practice location:
  • Phone: 949-495-9600
  • Fax: 949-249-7848
Mailing address:
  • Phone: 949-495-9600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDOS-1015
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code2080P0008X
TaxonomyPediatric Neurodevelopmental Disabilities Physician
License Number20A12878
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: