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General NPI Number Information
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NPI Number | 1538868369
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Entity Type | Organization
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Legal Business Name | OC ID SPECIALIST INC
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Dates
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Enumeration Date | 03/01/2023
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Last Update Date | 03/14/2023
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Provider Practice Location Address
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Address Line | 361 HOSPITAL RD STE 531
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3526
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Country | US
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Telephone | 949-375-6527
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Fax | 949-656-7001
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Provider Business Mailing Address
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Address Line | PO BOX 1942
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-1942
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Country | US
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Telephone | 949-375-6527
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Fax | 949-656-7001
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Authorized Official
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Title or Position | PRESIDENT
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Name | KHAING T MYINT
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Credential | MD
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Telephone | 949-375-6527
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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