Provider Demographics
NPI:1568848802
Name:ARMSTRONG, JENNIFER ALICE (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ALICE
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CARMEL BAY DR
Mailing Address - Street 2:
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-1006
Mailing Address - Country:US
Mailing Address - Phone:949-648-2907
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:949-706-2846
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-10
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA144516208D00000X
CAA144516207ZC0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical PathologyGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice