Provider Demographics
NPI:1609976414
Name:MARVIN D POSNER MD AND VIVIEN L PAN MD A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:MARVIN D POSNER MD AND VIVIEN L PAN MD A MEDICAL CORPORATION
Other - Org Name:PERINATAL ASSOCIATES OF ORANGE COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVIEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:PAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-364-4228
Mailing Address - Street 1:PO BOX 29482
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63126-7482
Mailing Address - Country:US
Mailing Address - Phone:949-643-3345
Mailing Address - Fax:949-643-3560
Practice Address - Street 1:27800 MEDICAL CENTER RD
Practice Address - Street 2:STUITE #100
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6410
Practice Address - Country:US
Practice Address - Phone:949-364-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0102310Medicaid
CAGR0102310Medicaid
CAZZZ66789ZOtherCA BLUE SHIELD
CAZZZ66789ZOtherCA BLUE SHIELD