Provider Demographics
NPI:1346643103
Name:JEFFREY LARRY TOPKIS, D.O., INC
Entity Type:Organization
Organization Name:JEFFREY LARRY TOPKIS, D.O., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:LARRY
Authorized Official - Last Name:TOPKIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:949-631-0988
Mailing Address - Street 1:PO BOX 15715
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92659-5715
Mailing Address - Country:US
Mailing Address - Phone:949-583-9944
Mailing Address - Fax:949-583-9955
Practice Address - Street 1:361 HOSPITAL RD
Practice Address - Street 2:124
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3522
Practice Address - Country:US
Practice Address - Phone:949-631-0988
Practice Address - Fax:949-631-2504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX44230Medicaid
CA00AX44230Medicaid
CAC64515Medicare UPIN