Organization
MEMORIAL PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAFAEL VERGARA M.D. (PRESIDENT)
(714) 898-1448
Entity
Organization
Contact information
Practice address
6042 BOLSA AVE, HUNTINGTON BEACH, CA 92647-2443
(714) 898-1448
(714) 898-8864
Mailing address
6042 BOLSA AVE, HUNTINGTON BEACH, CA 92647-2443
(714) 898-1448
(714) 898-8864
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A52192
CA
Other
Enumeration date
01/12/2007
Last updated
08/22/2020
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