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General NPI Number Information
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NPI Number | 1205142890
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Entity Type | Organization
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Legal Business Name | HARBOR VIEW INDUSTRIAL MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 08/20/2010
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Last Update Date | 08/20/2010
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Provider Practice Location Address
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Address Line | 1520 NUTMEG PL SUITE 112
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City | COSTA MESA
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State | CA
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Zip | 92626-2501
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Country | US
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Telephone | 714-352-3062
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Fax |
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Provider Business Mailing Address
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Address Line | 1520 NUTMEG PL SUITE 112
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City | COSTA MESA
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State | CA
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Zip | 92626-2501
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Country | US
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Telephone | 714-352-3062
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | REINA ARCHULETA
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Credential |
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Telephone | 714-437-9763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | FNP33050
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License Number State | CA
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