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General NPI Number Information
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NPI Number | 1225739113
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Entity Type | Organization
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Legal Business Name | CLARISSA DOI, MD
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Dates
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Enumeration Date | 03/16/2023
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Last Update Date | 03/16/2023
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Provider Practice Location Address
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Address Line | 2055 KELLOGG AVE
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City | CORONA
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State | CA
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Zip | 92879-3681
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Country | US
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Telephone | 951-415-6881
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Fax |
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Provider Business Mailing Address
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Address Line | 1968 S COAST HWY STE 368
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-3681
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Country | US
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Telephone | 951-415-6881
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CLARISSA DOI
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Credential |
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Telephone | 951-415-6881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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