Provider Demographics
NPI:1073601084
Name:C. DAMIRCHI, MD, INC. NEWPORT BEACH OFFICE
Entity Type:Organization
Organization Name:C. DAMIRCHI, MD, INC. NEWPORT BEACH OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CYRUS
Authorized Official - Middle Name:
Authorized Official - Last Name:DAMIRCHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-631-5252
Mailing Address - Street 1:901 DOVER DR STE 231
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5515
Mailing Address - Country:US
Mailing Address - Phone:949-631-5252
Mailing Address - Fax:949-631-1738
Practice Address - Street 1:901 DOVER DR STE 231
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-5515
Practice Address - Country:US
Practice Address - Phone:949-631-5252
Practice Address - Fax:949-631-1738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50298207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty