Healthcare Provider Details

I. General information

NPI: 1982635322
Provider Name (Legal Business Name): STANDIFORD HELM II, M.D. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24902 MOULTON PKWY SUITE 200
LAGUNA HILLS CA
92637-6410
US

IV. Provider business mailing address

PO BOX 2549
MISSION VIEJO CA
92690-0549
US

V. Phone/Fax

Practice location:
  • Phone: 949-462-0560
  • Fax: 949-462-3910
Mailing address:
  • Phone: 949-462-0560
  • Fax: 949-462-3910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberG38246
License Number StateCA

VIII. Authorized Official

Name: STANDIFORD HELM II
Title or Position: PRESIDENT
Credential: M.D.
Phone: 949-462-0560