Provider Demographics
NPI:1518237882
Name:MDM MEDICAL MGMT.
Entity Type:Organization
Organization Name:MDM MEDICAL MGMT.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:OXLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-553-9275
Mailing Address - Street 1:20072 SW BIRCH ST
Mailing Address - Street 2:SUITE 200-B
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-0794
Mailing Address - Country:US
Mailing Address - Phone:888-553-9275
Mailing Address - Fax:888-553-9285
Practice Address - Street 1:20072 SW BIRCH ST
Practice Address - Street 2:SUITE 200-B
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-0794
Practice Address - Country:US
Practice Address - Phone:888-553-9275
Practice Address - Fax:888-553-9285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty