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Organization
MARYAMPOURSARTIPMD INC.
Active
Organization
MARYAMPOURSARTIPMD INC.
Active
Other names
80/20 Quantum Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARYAM POURSARTIP MD (INTERNAL MEDICINE)
(917) 575-6669
Entity
Organization
Contact information
Practice address
665 CAMINO DE LOS MARES STE 305, SAN CLEMENTE, CA 92673-2841
(949) 371-9259
Mailing address
258 WHITE CAP LN, NEWPORT COAST, CA 92657-1088
(917) 575-6669
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/14/2021
Last updated
12/21/2021
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