MEDICARE: MR. JOHN C STORCH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	G050974	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G50974	OTHER	CA	STATE LICENSE

General Provider Information

NPI Number	:	1275577975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN C STORCH MD

Provider Business Mailing Address
First Line	:	421 SEVILLE AVE
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92661-1528
Country	:	US
Telephone Number	:	949-697-9037
Fax Number	:	949-258-5127

Provider Business Practice Location Address
First Line	:	421 SEVILLE AVE
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92661-1528
Country	:	US
Telephone Number	:	949-697-9037
Fax Number	:	949-258-5127

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	07/18/2023

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Directions to “ MR. JOHN C STORCH MD” Practice Location

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