Provider Demographics
NPI:1952313140
Name:ACACIO, BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:ACACIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27882 FORBES RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1267
Mailing Address - Country:US
Mailing Address - Phone:949-249-9200
Mailing Address - Fax:949-249-9203
Practice Address - Street 1:27882 FORBES RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1267
Practice Address - Country:US
Practice Address - Phone:949-249-9200
Practice Address - Fax:949-249-9203
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG80390207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G080390Medicare UPIN