Healthcare Provider Details

I. General information

NPI: 1194979336
Provider Name (Legal Business Name): P L HILPERT MD PHD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2008
Last Update Date: 11/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 AVOCADO SUITE 100
NEWPORT BEACH CA
92660
US

IV. Provider business mailing address

17151 NEWHOPE ST SUITE 201
FOUNTAIN VALLEY CA
92708-4226
US

V. Phone/Fax

Practice location:
  • Phone: 949-719-3600
  • Fax:
Mailing address:
  • Phone: 714-754-5804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG71277
License Number StateCA

VIII. Authorized Official

Name: PAMELA HILPERT
Title or Position: PRESIDENT
Credential: M.D.
Phone: 310-562-6736