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General NPI Number Information
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NPI Number | 1033799002
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Entity Type | Organization
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Legal Business Name | REDHILL MEDICAL CENTER INC
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 04/13/2021
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Provider Practice Location Address
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Address Line | 1442 IRVINE BLVD STE 101
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City | TUSTIN
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State | CA
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Zip | 92780-3845
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Country | US
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Telephone | 714-544-5007
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Fax |
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Provider Business Mailing Address
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Address Line | 1442 IRVINE BLVD STE 101
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City | TUSTIN
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State | CA
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Zip | 92780-3845
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Country | US
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Telephone | 714-544-5007
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | DANA BALLERINI
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Credential |
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Telephone | 714-544-5007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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