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General NPI Number Information
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NPI Number | 1871715854
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Entity Type | Organization
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Legal Business Name | MIKEL R WHITING, MD, INC
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 11/26/2007
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Provider Practice Location Address
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Address Line | 1440 N HARBOR BLVD SUITE 100
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City | FULLERTON
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State | CA
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Zip | 92835-4127
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Country | US
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Telephone | 714-870-0500
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Fax | 714-870-6230
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Provider Business Mailing Address
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Address Line | 1440 N HARBOR BLVD SUITE 100
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City | FULLERTON
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State | CA
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Zip | 92835-4127
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Country | US
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Telephone | 714-870-0500
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Fax | 714-870-6230
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MIKEL R WHITING
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Credential | M.D.
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Telephone | 714-870-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G36876
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License Number State | CA
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