Healthcare Provider Details
I. General information
NPI: 1013231893
Provider Name (Legal Business Name): CALIFORNIA PHYSICIAN CONSULTANTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/23/2010
Last Update Date: 04/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
26730 CROWN VALLEY PKWY SUITE 200
MISSION VIEJO CA
92691-6364
US
IV. Provider business mailing address
DEPT 5043
LOS ANGELES CA
90084-0001
US
V. Phone/Fax
- Phone: 949-505-2888
- Fax: 949-364-2110
- Phone: 330-470-3700
- Fax: 330-497-7940
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
E.
PAUL
REID
Title or Position: PRESIDENT
Credential: MD
Phone: 408-347-4051