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Organization

CANYON PACIFIC OB GYN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRUCE HAGADORN M.D. (OWNER)
(949) 753-0601
Entity
Organization

Contact information

Practice address
16300 SAND CANYON AVE, 805, IRVINE, CA 92618-3711
(949) 753-0601
Mailing address
16300 SAND CANYON AVE, 805, IRVINE, CA 92618-3711
(949) 753-0601

Taxonomy

Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
G71549
CA

Other

Enumeration date
03/23/2007
Last updated
04/22/2010
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