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General NPI Number Information
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NPI Number | 1508155102
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Entity Type | Organization
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Legal Business Name | ADOC ACQUISITION CO., A MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 04/04/2011
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Last Update Date | 04/04/2011
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Provider Practice Location Address
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Address Line | 12966 EUCLID ST STE 340
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City | GARDEN GROVE
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State | CA
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Zip | 92840-9205
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Country | US
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Telephone | 714-539-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 12966 EUCLID ST STE 340
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City | GARDEN GROVE
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State | CA
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Zip | 92840-9205
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Country | US
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Telephone | 714-539-3100
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Fax |
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Authorized Official
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Title or Position | CMO
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Name | DR. JOHN ERNSBERGER
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Credential | M.D.
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Telephone | 714-539-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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Taxonomy #2
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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 |
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Taxonomy #3
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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 |
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