Provider Demographics
NPI:1275577975
Name:STORCH, JOHN C (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:C
Last Name:STORCH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:421 SEVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92661-1528
Mailing Address - Country:US
Mailing Address - Phone:949-697-9037
Mailing Address - Fax:949-258-5127
Practice Address - Street 1:421 SEVILLE AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92661-1528
Practice Address - Country:US
Practice Address - Phone:949-697-9037
Practice Address - Fax:949-258-5127
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2023-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG050974207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG50974OtherSTATE LICENSE
F01491Medicare UPIN