Healthcare Provider Details
I. General information
NPI: 1710338256
Provider Name (Legal Business Name): ARC HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/27/2016
Last Update Date: 02/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
460 OLD NEWPORT BLVD
NEWPORT BEACH CA
92663-4211
US
IV. Provider business mailing address
460 OLD NEWPORT BLVD
NEWPORT BEACH CA
92663-4211
US
V. Phone/Fax
- Phone: 949-287-6880
- Fax: 949-258-5787
- Phone: 949-287-6880
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NR0400X |
| Taxonomy | Rehabilitation Chiropractor |
| License Number | CA31139 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | A93077 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | PT38468 |
| License Number State | CA |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | A93077 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
DAMIEN
JOHANN
BURGESS
Title or Position: PRESIDENT
Credential: D.C., M.S.
Phone: 714-618-7880