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Organization
OCEAN BREEZE MEDICAL GROUP, INC.
Active
Organization
OCEAN BREEZE MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICARDO DAVALOS M.D. (OWNER)
(949) 369-6993
Entity
Organization
Contact information
Practice address
150 AVENIDA CABRILLO STE A, SAN CLEMENTE, CA 92672-5595
(949) 369-6993
Mailing address
150 AVENIDA CABRILLO STE A, SAN CLEMENTE, CA 92672-5595
(949) 369-6993
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A065157
CA
Other
Enumeration date
01/25/2007
Last updated
12/13/2010
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