Healthcare Provider Details

I. General information

NPI: 1326365339
Provider Name (Legal Business Name): NPM CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2010
Last Update Date: 04/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 CORPORATE PLAZA DR SUITE 120
NEWPORT BEACH CA
92660-7920
US

IV. Provider business mailing address

12 CORPORATE PLAZA DR SUITE 120
NEWPORT BEACH CA
92660-7920
US

V. Phone/Fax

Practice location:
  • Phone: 949-706-6777
  • Fax: 949-706-5577
Mailing address:
  • Phone: 949-706-6777
  • Fax: 949-706-5577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberA35456
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberA35456
License Number StateCA

VIII. Authorized Official

Name: DR. R STEPHEN JENNINGS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 949-706-6777