Provider Demographics
NPI:1750308680
Name:ARMBRUSTER MEDICAL GROUP INC
Entity Type:Organization
Organization Name:ARMBRUSTER MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:ARMBRUSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-560-1580
Mailing Address - Street 1:PO BOX 1809
Mailing Address - Street 2:1210
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92856-0809
Mailing Address - Country:US
Mailing Address - Phone:714-560-1580
Mailing Address - Fax:710-560-1585
Practice Address - Street 1:15825 LAGUNA CANYON RD
Practice Address - Street 2:200
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2125
Practice Address - Country:US
Practice Address - Phone:949-341-3499
Practice Address - Fax:949-788-0556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG62516207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G625160Medicaid
CA00G625160OtherBLUE SHIELD
E74243Medicare UPIN
CAW18466Medicare PIN