Provider Demographics
NPI:1417054610
Name:ARTHUR ASTORINO JR MD, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:ARTHUR ASTORINO JR MD, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:ASTORINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-645-2250
Mailing Address - Street 1:1525 SUPERIOR AVE #101
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663
Mailing Address - Country:US
Mailing Address - Phone:949-645-2250
Mailing Address - Fax:949-645-9864
Practice Address - Street 1:1525 SUPERIOR AVE #101
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663
Practice Address - Country:US
Practice Address - Phone:949-645-2250
Practice Address - Fax:949-645-9864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41615207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A85669Medicare UPIN
IDW14037Medicare ID - Type Unspecified
WA41618BMedicare ID - Type Unspecified