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General NPI Number Information
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NPI Number | 1063616761
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Entity Type | Organization
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Legal Business Name | JUDY L. CORR, DO, INC
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 62 CORPORATE PARK SUITE #235
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City | IRVINE
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State | CA
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Zip | 92606-3122
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Country | US
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Telephone | 949-748-8866
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Fax | 949-748-8868
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Provider Business Mailing Address
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Address Line | 62 CORPORATE PARK SUITE #235
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City | IRVINE
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State | CA
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Zip | 92606-3122
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Country | US
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Telephone | 949-748-8866
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Fax | 949-748-8868
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Authorized Official
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Title or Position | OWNER
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Name | JUDY L. CORR
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Credential | DO
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Telephone | 949-748-8866
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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 | 20A4937
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License Number State | CA
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