Organization
TERMINO OFFICE - GASTROENTEROLOGY
Active
Parent organization
PEDIATRIC SUBSPECIALTY FACULTY, INC
Other names
Pediatric Subspecialty Faculty, Inc
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC SUBSPECIALTY FACULTY, INC
Authorized official
ELIZABETH M FARACE (MANAGER)
(714) 516-4295
Entity
Organization
Contact information
Practice address
1760 TERMINO AVE STE 300, LONG BEACH, CA 90804-2157
(714) 516-4295
Mailing address
455 S MAIN ST, ORANGE, CA 92868-3835
(714) 516-4295
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0090396
—
CA
05
—
GR0090404
—
CA
05
—
GR0090405
—
CA
05
—
GR0090406
—
CA
05
—
GR0090407
—
CA
05
—
GR0090409
—
CA
05
—
GR009040A
—
CA
Enumeration date
08/01/2007
Last updated
02/25/2008
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