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General NPI Number Information
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NPI Number | 1023009586
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Entity Type | Individual
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Provider Name | TERENCE R OFFENBERGER MD
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Gender | Male
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Dates
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Enumeration Date | 11/03/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 15 MAREBLU STE. 100
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City | ALISO VIEJO
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State | CA
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Zip | 92656-3015
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Country | US
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Telephone | 949-448-0656
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Fax | 949-425-2465
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Provider Business Mailing Address
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Address Line | 2501 PULLMAN ST
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City | SANTA ANA
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State | CA
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Zip | 92705-5511
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Country | US
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Telephone | 949-437-9063
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Fax | 949-437-9069
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A64290
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License Number State | CA
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