Organization
FOUNTAIN VALLEY OFFICE
Active
Parent organization
PEDIATRIC SUBSPECIALTY FACULTY, INC
Other names
Pediatric Subspecialty Faculty, Inc.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC SUBSPECIALTY FACULTY, INC
Authorized official
ELIZABETH M FARACE (MANAGER)
(714) 516-4295
Entity
Organization
Contact information
Practice address
11100 WARNER AVE STE 254, FOUNTAIN VALLEY, CA 92708-7502
(714) 516-4295
Mailing address
455 S MAIN ST, ORANGE, CA 92868-3835
(714) 516-4295
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
CA
Other
Enumeration date
08/01/2007
Last updated
08/01/2007
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