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General NPI Number Information
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NPI Number | 1821426537
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Entity Type | Organization
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Legal Business Name | JOHN C CHAMPION MD
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Dates
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Enumeration Date | 10/16/2013
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Last Update Date | 10/16/2013
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Provider Practice Location Address
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Address Line | 520 SUPERIOR AVE SUITE 290
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3637
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Country | US
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Telephone | 949-640-4014
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Fax | 949-640-4010
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Provider Business Mailing Address
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Address Line | PO BOX 16015
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City | NEWPORT BEACH
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State | CA
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Zip | 92659-6015
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Country | US
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Telephone | 949-640-4014
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Fax | 949-640-4010
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Authorized Official
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Title or Position | OWNER
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Name | JOHN CHRISTOPHER CHAMPION
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Credential | MD
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Telephone | 949-640-4014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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