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General NPI Number Information
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NPI Number | 1720385313
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Entity Type | Organization
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Legal Business Name | MONARCH MEDICAL MANGEMENT, INC.
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Dates
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Enumeration Date | 02/17/2011
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 3711 N HARBOR BLVD STE C
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City | FULLERTON
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State | CA
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Zip | 92835-1362
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Country | US
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Telephone | 714-773-4107
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Fax | 714-773-5806
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Provider Business Mailing Address
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Address Line | 13132 NEWPORT AVE STE 200
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City | TUSTIN
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State | CA
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Zip | 92780-3429
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Country | US
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Telephone | 714-368-3332
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Fax | 714-773-5806
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Authorized Official
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Title or Position | MEDICAL MANAGER BILLER
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Name | MISS K.C. CONTRERAS
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Credential | MA/LVN
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Telephone | 714-773-4107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | A31234
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License Number State | CA
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