| Endocrinology Medical Group Of Orange County Inc | |
|
725 W La Veta Ave 220 Orange CA 92868-4403 | |
| (714) 771-5700 | |
| (714) 771-7797 |
| Full Name | Endocrinology Medical Group Of Orange County Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 725 W La Veta Ave, Orange, California |
| Authorized Official Name and Position | Theresa A Bankhardt (ON SITE OFFICE MANAGER) |
| Authorized Official Contact | 7147715700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Endocrinology Medical Group Of Orange County Inc 725 W La Veta Ave 220 Orange CA 92868-4403 Ph: (714) 771-5700 | Endocrinology Medical Group Of Orange County Inc 725 W La Veta Ave 220 Orange CA 92868-4403 Ph: (714) 771-5700 |
| NPI Number | 1942499793 |
|---|---|
| Provider Enumeration Date | 10/17/2007 |
| Last Update Date | 11/20/2014 |
| Medicare PECOS PAC ID | 6103915301 |
|---|---|
| Medicare Enrollment ID | O20071210000681 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942499793 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | G25017 (California) | Primary |
| Provider Name | Priya K Shah |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1316129109 PECOS PAC ID: 2769556190 Enrollment ID: I20080804000357 |
| Provider Name | Aaron N Rockoff |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1902104839 PECOS PAC ID: 4587881750 Enrollment ID: I20140812001044 |
| Provider Name | Cynthia Antonio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962745554 PECOS PAC ID: 6204189384 Enrollment ID: I20181019002581 |
| Provider Name | Keirsten D Montgomery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023261492 PECOS PAC ID: 1951632900 Enrollment ID: I20191007001018 |
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