Organization
BRISTOL PARK MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK D SCHAFER MD (MEDICAL DIRECTOR)
(714) 665-1600
Entity
Organization
Contact information
Practice address
3010 W ORANGE AVE, ANAHEIM, CA 92804-3172
(714) 826-1200
(714) 229-5399
Mailing address
2742 DOW AVE, TUSTIN, CA 92780-7242
(714) 665-1600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR006919A
—
CA
Enumeration date
05/28/2006
Last updated
10/15/2008
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