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General NPI Number Information
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NPI Number | 1851012058
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Entity Type | Organization
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Legal Business Name | JOSEPH L. DINGLASAN SR. MD INC.
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Dates
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Enumeration Date | 09/06/2022
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 14642 NEWPORT AVE STE 105
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City | TUSTIN
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State | CA
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Zip | 92780-6058
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Country | US
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Telephone | 949-889-2212
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Fax | 702-867-1669
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Provider Business Mailing Address
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Address Line | 1 PETERS CANYON RD STE 160
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City | IRVINE
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State | CA
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Zip | 92606-1748
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Country | US
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Telephone | 626-826-2546
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Fax | 702-867-1669
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | LINDA MACK
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Credential |
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Telephone | 626-826-2546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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