Provider Demographics
NPI:1356614937
Name:PROSPICE PHYSICAL MEDICINE CENTERS
Entity type:Organization
Organization Name:PROSPICE PHYSICAL MEDICINE CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMNIK
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-476-2073
Mailing Address - Street 1:5630 E SANTA ANA CANYON RD
Mailing Address - Street 2:STE. 150
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-3126
Mailing Address - Country:US
Mailing Address - Phone:714-476-2073
Mailing Address - Fax:951-537-6931
Practice Address - Street 1:5630 E SANTA ANA CANYON RD
Practice Address - Street 2:STE. 150
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-3126
Practice Address - Country:US
Practice Address - Phone:714-476-2073
Practice Address - Fax:951-537-6931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC3420564261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty