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General NPI Number Information
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NPI Number | 1760922413
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Entity Type | Organization
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Legal Business Name | BETTINA LIMJOCO MDPC
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Dates
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Enumeration Date | 02/28/2017
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Last Update Date | 02/28/2017
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Provider Practice Location Address
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Address Line | 20072 SW BIRCH ST SUITE 170
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-0794
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Country | US
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Telephone | 949-891-0945
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Fax | 949-201-9824
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Provider Business Mailing Address
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Address Line | 20072 SW BIRCH ST SUITE 170
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-0794
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Country | US
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Telephone | 949-891-0945
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Fax | 949-201-9824
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | BETTINA TAYENGCO LIMJOCO
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Credential | M.D.
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Telephone | 304-840-8406
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | C51899
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License Number State | CA
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