Organization
GLENN D. MADOKORO, M.D, F.A.C.G., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN DOUGLAS MADOKORO M.D. (PRESIDENT)
(949) 548-8800
Entity
Organization
Contact information
Practice address
351 HOSPITAL RD, SUITE 210, NEWPORT BEACH, CA 92663-3509
(949) 548-8800
(949) 548-0248
Mailing address
351 HOSPITAL ROAD, SUITE 210, NEWPORT BEACH, CA 92663-3509
(949) 548-8800
(949) 548-0248
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G30192
CA
Other
Enumeration date
05/11/2007
Last updated
08/24/2010
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