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General NPI Number Information
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NPI Number | 1639656465
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Entity Type | Organization
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Legal Business Name | REGEN BIOCARE INC
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Dates
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Enumeration Date | 07/24/2018
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Last Update Date | 07/24/2018
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Provider Practice Location Address
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Address Line | 3300 IRVINE AVE STE 307
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-3108
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Country | US
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Telephone | 949-724-1800
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Fax | 949-724-1811
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Provider Business Mailing Address
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Address Line | 3300 IRVINE AVE STE 307
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-3108
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Country | US
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Telephone | 949-724-1800
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Fax | 949-724-1811
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Authorized Official
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Title or Position | BILLING
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Name | MARY EBERHART
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Credential |
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Telephone | 949-724-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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