Organization
EMMANUEL JUSTICE ADDO MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMMANUEL JUSTICE ADDO M.D. (PRESIDENT)
(800) 883-7243
Entity
Organization
Contact information
Practice address
20301 SW BIRCH ST STE 102, NEWPORT BEACH, CA 92660-1754
(949) 251-1502
(714) 647-1245
Mailing address
210 N TUSTIN AVE, SANTA ANA, CA 92705-3807
(800) 883-7243
(714) 647-1245
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A83783
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A837830
—
CA
Enumeration date
07/28/2006
Last updated
11/11/2015
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