Organization
PEDIATRIC SUBSPECIALTY FACULTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE NUGENT MD (MEDICAL DIRECTOR OF HEMATOLOGY)
(714) 532-8649
Entity
Organization
Contact information
Practice address
455 S MAIN ST, ORANGE, CA 92868-3835
(714) 532-8649
Mailing address
455 S MAIN ST, ORANGE, CA 92868-3835
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/14/2010
Last updated
07/14/2010
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