| Memorial Research Medical Clinic | |
|
14351 Myford Rd Suite B Tustin CA 92780-7045 | |
| (714) 550-9990 | |
| (714) 210-7087 |
| Full Name | Memorial Research Medical Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 14351 Myford Rd, Tustin, California |
| Authorized Official Name and Position | Joel M Neutel (MED DIRECTOR) |
| Authorized Official Contact | 7145509990 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Memorial Research Medical Clinic 14351 Myford Rd Suite B Tustin CA 92780-7045 Ph: (714) 550-9990 | Memorial Research Medical Clinic 14351 Myford Rd Suite B Tustin CA 92780-7045 Ph: (714) 550-9990 |
| NPI Number | 1720256415 |
|---|---|
| Provider Enumeration Date | 02/14/2008 |
| Last Update Date | 07/30/2008 |
| Medicare PECOS PAC ID | 5294625844 |
|---|---|
| Medicare Enrollment ID | O20040317000928 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720256415 | NPI | - | NPPES |
| A50551 | Other | CA | LICENSE NO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A50551 (California) | Primary |
| Provider Name | Joel M Neutel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730163965 PECOS PAC ID: 2264691872 Enrollment ID: I20120316000273 |
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