Individual
MAUREEN C JENSEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
ONE HOAG DRIVE, NEWPORT BEACH, CA 92663-4162
(949) 764-5570
(949) 263-0473
Mailing address
PO BOX 3095, NEWPORT BEACH, CA 92659-0659
(949) 764-5570
(949) 263-0473
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G61494
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G614940
BLUE SHIELD
CA
05
—
00G614940
—
CA
Enumeration date
06/08/2006
Last updated
07/08/2007
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