Individual
DON S MINCKLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 456-8068
(714) 456-3765
Mailing address
PO BOX 51055, LOS ANGELES, CA 90051-5355
(714) 456-8068
(714) 456-3765
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
G33305
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G333050
BLUE SHIELD
CA
05
—
00G333050
—
CA
01
—
WG33305D
MEDICARE PTAN
CA
Enumeration date
07/07/2006
Last updated
09/26/2019
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