Healthcare Provider Details

I. General information

NPI: 1467579565
Provider Name (Legal Business Name): COMPREHENSIVE HEALTH CARE SPECIALISTS, MED. GROUP., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 12/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13522 NEWPORT AVE STE 102
TUSTIN CA
92780-3707
US

IV. Provider business mailing address

13522 NEWPORT AVE STE 102
TUSTIN CA
92780-3707
US

V. Phone/Fax

Practice location:
  • Phone: 714-573-8200
  • Fax: 714-573-9401
Mailing address:
  • Phone: 714-573-8200
  • Fax: 714-573-9401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA61648
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA62358
License Number StateCA

VIII. Authorized Official

Name: DR. ROBERT C SCHREIMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 714-573-8200