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General NPI Number Information
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NPI Number | 1578829024
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Entity Type | Individual
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Provider Name | MINDY MICHELE FINFROCK M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/10/2012
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Last Update Date | 07/15/2019
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Provider Practice Location Address
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Address Line | 4968 BOOTH CIR
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City | IRVINE
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State | CA
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Zip | 92604-3360
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Country | US
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Telephone | 949-387-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 1401 AVOCADO AVE STE 709
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-8714
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Country | US
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Telephone | 949-759-1720
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 53631
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License Number State | TN
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