Organization
BALBOA PALMS
Active
Organization
BALBOA PALMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOE MUNGUIA (MEMBER)
(323) 772-6785
Entity
Organization
Contact information
Practice address
2700 NEWPORT BLVD STE 164, NEWPORT BEACH, CA 92663-3735
(323) 772-6785
Mailing address
2700 NEWPORT BLVD STE 164, NEWPORT BEACH, CA 92663-3735
(323) 772-6785
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/17/2019
Last updated
10/17/2019
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