Provider Demographics
NPI:1801980669
Name:CHAMPION, JOHN C (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:C
Last Name:CHAMPION
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3080 BRISTOL ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-3093
Mailing Address - Country:US
Mailing Address - Phone:949-640-4014
Mailing Address - Fax:949-640-4010
Practice Address - Street 1:520 SUPERIOR AVE
Practice Address - Street 2:SUITE 290
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3637
Practice Address - Country:US
Practice Address - Phone:949-640-4014
Practice Address - Fax:949-640-4010
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2016-05-25
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Provider Licenses
StateLicense IDTaxonomies
CAC53134207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
H05787Medicare UPIN