Organization
DAVID L. WIRTA M.D. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID L WIRTA M.D. (PRESIDENT/ CEO)
(949) 650-1863
Entity
Organization
Contact information
Practice address
520 SUPERIOR AVE, SUITE 235, NEWPORT BEACH, CA 92663-3637
(949) 650-1863
Mailing address
1501 SUPERIOR AVE, SUITE 303, NEWPORT BEACH, CA 92663
(949) 650-1863
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G081350
CA
Other
Enumeration date
09/01/2010
Last updated
09/01/2010
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