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General NPI Number Information
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NPI Number | 1154329266
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Entity Type | Organization
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Legal Business Name | UROLOGICAL MEDICAL GROUP OF NORTH ORANGE COUNTY
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 1400 N HARBOR BLVD STE 300
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City | FULLERTON
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State | CA
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Zip | 92835-4145
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Country | US
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Telephone | 714-830-5970
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Fax | 714-870-4792
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Provider Business Mailing Address
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Address Line | 1400 N HARBOR BLVD STE 300
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City | FULLERTON
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State | CA
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Zip | 92835-4145
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Country | US
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Telephone | 714-830-5970
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Fax | 714-870-4792
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Authorized Official
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Title or Position | PARTNER
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Name | DR. ERIC BRENDAN TYGENHOF
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Credential |
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Telephone | 323-865-3700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | A65760
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License Number State | CA
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