Healthcare Provider Details

I. General information

NPI: 1548509102
Provider Name (Legal Business Name): ELIZABETH ANNE KOVACS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH ANNE KOVACS NP

II. Dates (important events)

Enumeration Date: 02/01/2013
Last Update Date: 02/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 W LA VETA AVE STE 610
ORANGE CA
92868-4300
US

IV. Provider business mailing address

1010 W LA VETA AVE STE 610
ORANGE CA
92868-4300
US

V. Phone/Fax

Practice location:
  • Phone: 714-285-2311
  • Fax:
Mailing address:
  • Phone: 714-285-2311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number584459
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number21725
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: