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Organization
BRISTOL PARK MEDICAL GROUP, INC.
Active
Organization
BRISTOL PARK MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK D SCHAFER MD (MEDICAL DIRECTOR)
(714) 665-1661
Entity
Organization
Contact information
Practice address
1212 W 17TH ST, SANTA ANA, CA 92706-3418
(714) 954-0432
(714) 796-6265
Mailing address
2742 DOW AVE, TUSTIN, CA 92780-7242
(714) 665-1600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR006919H
—
CA
Enumeration date
05/28/2006
Last updated
10/15/2008
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