Organization
ENDOCRINOLOGY MEDICAL GROUP OF ORANGE COUNTY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA A BANKHARDT (ON SITE OFFICE MANAGER)
(714) 771-5700
Entity
Organization
Contact information
Practice address
725 W LA VETA AVE, 220, ORANGE, CA 92868-4403
(714) 771-5700
(714) 771-7797
Mailing address
725 W LA VETA AVE, 220, ORANGE, CA 92868-4403
(714) 771-5700
(714) 771-7797
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
G25017
CA
Other
Enumeration date
10/17/2007
Last updated
11/20/2014
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