Organization
IRVINE PHYSICIANS MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANILO JARAVATA M.D. (PRESIDENT)
(800) 883-7243
Entity
Organization
Contact information
Practice address
3700 SOUTH ST, LAKEWOOD, CA 90712-1419
(800) 883-7243
Mailing address
210 N TUSTIN AVE, SANTA ANA, CA 92705-3807
(800) 883-7243
(714) 647-1245
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A52971
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A529710
—
CA
Enumeration date
10/04/2006
Last updated
12/30/2007
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