Provider Demographics
NPI:1659319259
Name:EEH MEDICAL CORPORATION
Entity Type:Organization
Organization Name:EEH MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-719-3600
Mailing Address - Street 1:1601 AVOCADO AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7725
Mailing Address - Country:US
Mailing Address - Phone:949-719-3600
Mailing Address - Fax:949-644-7344
Practice Address - Street 1:1601 AVOCADO AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7725
Practice Address - Country:US
Practice Address - Phone:949-719-3600
Practice Address - Fax:949-644-7344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty