Provider Demographics
NPI:1366858615
Name:PEDIATRIC NEUROLOGY OF ORANGE COUNTY, PC
Entity Type:Organization
Organization Name:PEDIATRIC NEUROLOGY OF ORANGE COUNTY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARFINKLE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:949-495-9600
Mailing Address - Street 1:30131 TOWN CENTER DR
Mailing Address - Street 2:SUITE 245
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-2034
Mailing Address - Country:US
Mailing Address - Phone:949-495-9600
Mailing Address - Fax:949-249-7848
Practice Address - Street 1:30131 TOWN CENTER DR
Practice Address - Street 2:SUITE 245
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-2034
Practice Address - Country:US
Practice Address - Phone:949-495-9600
Practice Address - Fax:949-249-7848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-08
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12878261Q00000X, 261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center