Organization
CONSORTIO HEALTHCARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY LYN MOTTA M.D. (PRESIDENT/OWNER)
(714) 505-0800
Entity
Organization
Contact information
Practice address
12791 NEWPORT AVE, SUITE 201, TUSTIN, CA 92780-8023
(714) 505-0800
(714) 505-0139
Mailing address
12791 NEWPORT AVE, SUITE 201, TUSTIN, CA 92780-8023
(714) 505-0800
(714) 505-0139
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A65953
CA
Other
Enumeration date
09/29/2009
Last updated
09/29/2009
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