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General NPI Number Information
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NPI Number | 1659630622
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Entity Type | Organization
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Legal Business Name | THOMAS J ASCIUTO MD CORPORATION
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Dates
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Enumeration Date | 05/11/2012
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Last Update Date | 09/26/2012
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Provider Practice Location Address
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Address Line | 18111 BROOKHURST ST SUITE 4600
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-6728
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Country | US
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Telephone | 714-861-4545
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Fax | 714-861-4549
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Provider Business Mailing Address
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Address Line | 18111 BROOKHURST ST SUITE 4600
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-6728
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Country | US
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Telephone | 714-861-4545
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Fax | 714-861-4549
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. THOMAS J ASCIUTO
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Credential | M.D.
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Telephone | 714-861-4545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State | CA
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