Provider Demographics
NPI:1407499569
Name:JENNIFER ARMSTRONG, M.D., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:JENNIFER ARMSTRONG, M.D., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ALICE
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-706-2887
Mailing Address - Street 1:369 SAN MIGUEL DR STE 235
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7816
Mailing Address - Country:US
Mailing Address - Phone:949-706-2887
Mailing Address - Fax:
Practice Address - Street 1:369 SAN MIGUEL DR STE 235
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7816
Practice Address - Country:US
Practice Address - Phone:949-706-2887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty