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General NPI Number Information
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NPI Number | 1841404142
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Entity Type | Organization
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Legal Business Name | CADUCEUS PHYSICIANS MEDICAL GROUP
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | 333 THALIA ST
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-2713
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Country | US
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Telephone | 949-499-0577
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Fax |
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Provider Business Mailing Address
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Address Line | 18200 YORBA LINDA BLVD STE #401
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City | YORBA LINDA
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State | CA
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Zip | 92886-4056
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Country | US
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Telephone | 714-646-8008
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Fax |
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Authorized Official
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Title or Position | MSO MANAGER
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Name | MRS. REBECCA JAMES
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Credential |
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Telephone | 714-646-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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