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General NPI Number Information
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NPI Number | 1043428188
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Entity Type | Organization
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Legal Business Name | PRIVATE PHYSICIANS MEDICAL ASSOCIATES
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 08/10/2011
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Provider Practice Location Address
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Address Line | 520 SUPERIOR AVE SUITE 285
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3637
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Country | US
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Telephone | 949-566-8179
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Fax | 888-565-6545
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Provider Business Mailing Address
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Address Line | 520 SUPERIOR AVE SUITE 285
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3637
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Country | US
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Telephone | 949-566-8179
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Fax | 888-565-6545
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Authorized Official
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Title or Position | OWNER
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Name | VANMETER RICHARD LAWRENCE
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Credential | MD
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Telephone | 714-379-8585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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