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General NPI Number Information
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NPI Number | 1366858615
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Entity Type | Organization
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Legal Business Name | PEDIATRIC NEUROLOGY OF ORANGE COUNTY, PC
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Dates
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Enumeration Date | 07/08/2014
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Last Update Date | 07/08/2014
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Provider Practice Location Address
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Address Line | 30131 TOWN CENTER DR SUITE 245
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-2034
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Country | US
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Telephone | 949-495-9600
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Fax | 949-249-7848
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Provider Business Mailing Address
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Address Line | 30131 TOWN CENTER DR SUITE 245
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-2034
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Country | US
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Telephone | 949-495-9600
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Fax | 949-249-7848
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. REBECCA GARFINKLE
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Credential | D.O.
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Telephone | 949-495-9600
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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 | 20A12878
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number | 20A12878
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License Number State | CA
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