Provider Demographics
NPI:1942453584
Name:ENDOCRINE MEDICAL-HOME, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ENDOCRINE MEDICAL-HOME, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:HONGBUOM
Authorized Official - Last Name:RHIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-548-2114
Mailing Address - Street 1:19 BORDEAUX
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-6806
Mailing Address - Country:US
Mailing Address - Phone:949-439-8832
Mailing Address - Fax:949-706-1558
Practice Address - Street 1:320 SUPERIOR AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-2716
Practice Address - Country:US
Practice Address - Phone:949-439-8832
Practice Address - Fax:714-634-3980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33629207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty