Healthcare Provider Details

I. General information

NPI: 1538381751
Provider Name (Legal Business Name): WOMEN'S PRIMARY HEALTH PHYSICIANS-ORANGE COUNTY, A MEDICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 07/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 W. STEWART DRIVE SUITE 406
ORANGE CA
92868
US

IV. Provider business mailing address

P.O. BOX 2638
LAGUNA HILLS CA
92654-2638
US

V. Phone/Fax

Practice location:
  • Phone: 949-487-2850
  • Fax: 949-487-0332
Mailing address:
  • Phone: 949-487-2850
  • Fax: 949-487-0332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VH0002X
TaxonomyHospice and Palliative Medicine (Obstetrics & Gynecology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. E. PETER ANZALDO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 949-487-2850