Provider Demographics
NPI:1346641735
Name:PACIFIC OBSTETRICS & GYNECOLOGY
Entity Type:Organization
Organization Name:PACIFIC OBSTETRICS & GYNECOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-548-6800
Mailing Address - Street 1:496 OLD NEWPORT BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4264
Mailing Address - Country:US
Mailing Address - Phone:949-548-6800
Mailing Address - Fax:949-548-6801
Practice Address - Street 1:496 OLD NEWPORT BLVD STE 4
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4264
Practice Address - Country:US
Practice Address - Phone:949-548-6800
Practice Address - Fax:949-548-6801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA68416174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty