Organization
BATAVIA WOODS - ALLERGY
Active
Other names
Pediatric Subspecialty Faculty, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH M FARACE (MANAGER)
(714) 516-4295
Entity
Organization
Contact information
Practice address
725 W. LAVETA, SUITE 100, ORANGE, CA 92868-3835
(714) 516-4295
Mailing address
455 S MAIN ST, ORANGE, CA 92868-3835
(714) 516-4295
Taxonomy
Speciality
Code
Description
License number
State
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0090394
—
CA
05
—
GR0090400
—
CA
05
—
GR0090401
—
CA
05
—
GR0090402
—
CA
05
—
GR0090403
—
CA
Enumeration date
08/07/2007
Last updated
02/25/2008
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