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General NPI Number Information
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NPI Number | 1497702724
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Entity Type | Organization
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Legal Business Name | CADUCEUS PHYSICIANS MEDICAL GROUP
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 04/27/2023
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Provider Practice Location Address
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Address Line | 18200 YORBA LINDA BLVD STE 250
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City | YORBA LINDA
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State | CA
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Zip | 92886-4044
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Country | US
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Telephone | 714-646-8000
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Fax | 714-572-2562
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Provider Business Mailing Address
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Address Line | 18200 YORBA LINDA BLVD STE 111
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City | YORBA LINDA
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State | CA
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Zip | 92886-4043
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Country | US
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Telephone | 714-646-8000
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Fax | 714-572-2562
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Authorized Official
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Title or Position | CEO
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Name | GREGG DENICOLA
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Credential | MD
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Telephone | 714-646-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | CA
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Taxonomy #8
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State | CA
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Taxonomy #9
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State | CA
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Taxonomy #10
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | CA
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Taxonomy #11
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State | CA
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Taxonomy #12
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Taxonomy Code | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number |
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License Number State | CA
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Taxonomy #13
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State | CA
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Taxonomy #15
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | CA
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