Healthcare Provider Details

I. General information

NPI: 1700516580
Provider Name (Legal Business Name): NICHOLAS BIJAN POMBO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2022
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 W STEWART DR
ORANGE CA
92868-3891
US

IV. Provider business mailing address

70 QUARTER HORSE
IRVINE CA
92602-0201
US

V. Phone/Fax

Practice location:
  • Phone: 714-771-8000
  • Fax:
Mailing address:
  • Phone: 949-309-9277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA207026
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: