Individual
NANCY J COUNCELBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
16300 SAND CANYON AVE, 311, IRVINE, CA 92618-3711
(949) 753-7475
(949) 753-8797
Mailing address
16300 SAND CANYON AVE, 311, IRVINE, CA 92618-3711
(949) 753-7475
(949) 753-8797
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
G57005
CA
Other
Enumeration date
09/02/2006
Last updated
07/08/2007
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