Organization
HARBOR PEDIATRIC MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID ANTHONY MICHELIS MD (OWNER)
(949) 645-4670
Entity
Organization
Contact information
Practice address
601 DOVER DR STE 7, NEWPORT BEACH, CA 92663-5721
(949) 465-4670
(949) 722-6866
Mailing address
601 DOVER DR STE 7, NEWPORT BEACH, CA 92663-5721
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
261Q00000X
Clinic/Center
—
CA
Other
Enumeration date
08/02/2006
Last updated
01/11/2012
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