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General NPI Number Information
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NPI Number | 1679375273
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Entity Type | Organization
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Legal Business Name | CIFUENTES MEDICAL GROUP
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Dates
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Enumeration Date | 03/25/2025
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 2901 E KATELLA AVE STE A
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City | ORANGE
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State | CA
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Zip | 92867-5248
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Country | US
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Telephone | 949-209-5775
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Fax | 949-209-5542
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Provider Business Mailing Address
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Address Line | 9842 BRILEY WAY
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City | VILLA PARK
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State | CA
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Zip | 92861-3116
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Country | US
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Telephone | 209-681-6227
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. RODRIGO KENNOSUKE CIFUENTES TESHIMA
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Credential | MD
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Telephone | 209-681-6227
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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 | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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