Healthcare Provider Details

I. General information

NPI: 1881728426
Provider Name (Legal Business Name): ANDRES DELUNA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 10/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 SOUTH PARKER STREET SUITE 100
ORANGE CA
92868
US

IV. Provider business mailing address

3080 BRISTOL ST SUITE 600
COSTA MESA CA
92626-3093
US

V. Phone/Fax

Practice location:
  • Phone: 714-727-0913
  • Fax: 657-622-3024
Mailing address:
  • Phone: 714-445-0220
  • Fax: 714-445-0246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA93352
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: