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General NPI Number Information
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NPI Number | 1831186410
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Entity Type | Organization
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Legal Business Name | DOCTORS OF CHILDREN MEDICAL CORPORATION
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Dates
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Enumeration Date | 09/29/2005
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Last Update Date | 12/02/2015
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Provider Practice Location Address
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Address Line | 4950 BARRANCA PKWY SUITE 209
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City | IRVINE
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State | CA
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Zip | 92604-4671
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Country | US
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Telephone | 949-654-2800
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Fax | 949-654-2804
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Provider Business Mailing Address
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Address Line | 4950 BARRANCA PKWY SUITE 209
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City | IRVINE
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State | CA
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Zip | 92604-4671
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Country | US
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Telephone | 949-654-2800
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Fax | 949-654-2804
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MEIGAN EVERTS
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Credential | M.D.
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Telephone | 949-654-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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