Provider Demographics
NPI:1083857908
Name:LANCE H. BETSON, D.O. A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:LANCE H. BETSON, D.O. A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:H
Authorized Official - Last Name:BETSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:949-548-3441
Mailing Address - Street 1:351 HOSPITAL RD STE 210
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3504
Mailing Address - Country:US
Mailing Address - Phone:949-548-3441
Mailing Address - Fax:949-548-2074
Practice Address - Street 1:351 HOSPITAL RD STE 210
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3504
Practice Address - Country:US
Practice Address - Phone:949-548-3441
Practice Address - Fax:949-548-2074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-07
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7341207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty