Organization
CADUCEUS PHYSICIANS MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAY WEAVER (VICE PRESIDENT)
(714) 646-8000
Entity
Organization
Contact information
Practice address
18300 YORBA LINDA BLVD, SUITE 204, YORBA LINDA, CA 92886-4052
(714) 577-6031
Mailing address
18200 YORBA LINDA BLVD, SUITE 401, YORBA LINDA, CA 92886-4056
(714) 646-8000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G47766
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G47766
LICENSE
CA
Enumeration date
09/21/2007
Last updated
07/11/2008
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