Healthcare Provider Details

I. General information

NPI: 1679063127
Provider Name (Legal Business Name): MICHAEL DEL JUNCO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2018
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 W STEWART DR STE 607
ORANGE CA
92868-3857
US

IV. Provider business mailing address

1310 W STEWART DR STE 607
ORANGE CA
92868-3857
US

V. Phone/Fax

Practice location:
  • Phone: 714-919-8141
  • Fax: 714-919-8142
Mailing address:
  • Phone: 714-919-8141
  • Fax: 714-919-8142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number173376
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: