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CANYON PACIFIC OB GYN NPI 1134246317


NPI Information

NPI: 1134246317
Provider Name: CANYON PACIFIC OB GYN
Classification: Obstetrics & Gynecology - 207VX0000X
Entity Type: Organization

Specialization: Obstetrics

Address:
16300 SAND CANYON AVE
805
IRVINE, CA
ZIP 92618
Phone: (949) 753-0601
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CANYON PACIFIC OB GYN is an obstetrics obstetrics gynecology in Irvine, CA. The provider is a physician who specializes in diagnosis, treatment, and management of patients with obstetric conditions. Source: National Uniform Claim Committee CANYON PACIFIC OB GYN NPI is 1134246317. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

16300 SAND CANYON AVE
805
IRVINE, CA
ZIP 92618-711
Phone: (949) 753-0601

The provider's authorized official is Bruce Hagadorn .
The authorized official title is Owner and has the following contact phone number (949) 753-0601.

The enumeration date for this NPI number is 3/23/2007 and was last updated on 4/22/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207VX0000XObstetrics & GynecologyObstetricsG71549CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1F71396MEDICARE UPINCALIFORNIA
2W13035MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAMEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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