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General NPI Number Information
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NPI Number | 1003562398
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Entity Type | Organization
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Legal Business Name | JMC MEDICAL CORPORATION
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Dates
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Enumeration Date | 02/24/2022
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 2001 WESTCLIFF DR STE 301
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-5553
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Country | US
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Telephone | 617-784-4682
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 WESTCLIFF DR STE 301
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-5553
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Country | US
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Telephone | 617-784-4682
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DR. JORGE MAURICIO CASTELLANOS
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Credential | MD
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Telephone | 617-784-4682
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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