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General NPI Number Information
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NPI Number | 1396916672
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Entity Type | Organization
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Legal Business Name | MICHAEL OEFELEIN, MD
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Dates
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Enumeration Date | 03/14/2008
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Last Update Date | 07/13/2009
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Provider Practice Location Address
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Address Line | 3302 LAVIANA ST
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City | TUSTIN
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State | CA
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Zip | 92782-1926
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Country | US
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Telephone | 949-285-0056
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Fax |
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Provider Business Mailing Address
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Address Line | 3302 LAVIANA STREET
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City | TUSTIN
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State | CA
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Zip | 92782-1926
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Country | US
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Telephone | 949-285-0056
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Fax |
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Authorized Official
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Title or Position | UROLOGIST
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Name | DR. MICHAEL G. OEFELEIN
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Credential | MD, FACS
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Telephone | 949-285-0056
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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 | 11473
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | G88466
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License Number State | CA
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