MEDICARE: ARMANDO ESPINO REBOLLAR

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	174400000X	Specialist	L9911	CA

General Provider Information

NPI Number	:	1689487027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARMANDO ESPINO REBOLLAR

Provider Business Mailing Address
First Line	:	404 WESTMINSTER AVE STE 2
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-4237
Country	:	US
Telephone Number	:	657-289-8733
Fax Number	:

Provider Business Practice Location Address
First Line	:	404 WESTMINSTER AVE STE 2
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-4237
Country	:	US
Telephone Number	:	657-289-8733
Fax Number	:

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

Provider Enumeration Date	:	01/29/2025
Last Update Date	:	01/29/2025

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Directions to “ ARMANDO ESPINO REBOLLAR ” Practice Location

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