Organization
GASTROINTESTINAL & LIVER DISEASES OF NEWPORT, A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EUGENE R PANTANGCO M.D. (OWNER)
(626) 840-8419
Entity
Organization
Contact information
Practice address
1525 SUPERIOR AVE, STE 208, NEWPORT BEACH, CA 92663-3639
(626) 840-8419
(949) 705-6774
Mailing address
PO BOX 9409, NEWPORT BEACH, CA 92658-9409
(626) 840-8419
(949) 705-6774
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A74336
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A744360
—
CA
Enumeration date
10/17/2006
Last updated
02/17/2009
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