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General NPI Number Information
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NPI Number | 1821014259
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Entity Type | Organization
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Legal Business Name | OCEAN PACIFIC MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 01/15/2013
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Provider Practice Location Address
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Address Line | 31852 COAST HWY SUITE 301
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-6764
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Country | US
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Telephone | 949-218-5959
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Fax | 949-218-4949
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Provider Business Mailing Address
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Address Line | 67 S PEAK
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-2903
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Country | US
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Telephone | 949-218-5959
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Fax | 949-218-4949
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Authorized Official
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Title or Position | CEO
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Name | DR. JOE K WONG
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Credential | M.D.
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Telephone | 949-218-5959
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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 | FNP32699
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License Number State | CA
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