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General NPI Number Information
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NPI Number | 1376742700
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Entity Type | Individual
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Provider Name | JOSE PUANGCO M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 510 SUPERIOR AVE SUITE 200-A
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3663
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Country | US
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Telephone | 949-764-8070
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Fax |
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Provider Business Mailing Address
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Address Line | 510 SUPERIOR AVE SUITE 200-A
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3663
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Country | US
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Telephone | 949-764-8070
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number | A91074
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | A91074
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | A91074
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 2084N0008X
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Taxonomy Name | Neuromuscular Medicine (Psychiatry & Neurology) Physician
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License Number | A91074
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | A91074
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License Number State | CA
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