Organization
HERITAGE 88 HOLDINGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VANESSA DUMONT (NURSE PRACTITIONER)
(415) 250-6769
Entity
Organization
Contact information
Practice address
280 S MAIN ST STE 100, ORANGE, CA 92868-3852
(714) 704-1900
Mailing address
2256 HERITAGE DR, COSTA MESA, CA 92627-1679
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
02/03/2021
Last updated
02/03/2021
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