Healthcare Provider Details

I. General information

NPI: 1306983812
Provider Name (Legal Business Name): WESTMINSTER MEDICAL OFFICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13671 BEACH BLVD STE A
WESTMINSTER CA
92683-3200
US

IV. Provider business mailing address

13671 BEACH BLVD STE A
WESTMINSTER CA
92683-3200
US

V. Phone/Fax

Practice location:
  • Phone: 714-467-4321
  • Fax: 714-467-4311
Mailing address:
  • Phone: 714-467-4321
  • Fax: 714-467-4311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMN1982152
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMP2557025
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA69222
License Number StateCA

VIII. Authorized Official

Name: TAMMY DO
Title or Position: CLINIC MANAGER
Credential:
Phone: 714-769-5167