Organization Name: | MICHAEL ADAM WALDMAN, M.D. |
NPI Number: | 1346436342 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL ADAM WALDMAN (CEO) |
Mailing Address: | 2 Hughes Suite 175 Irvine |
State: | CA US |
Postal Code: | 926182056 |
Phone Number: | 9496008260 |
Fax Number: | 9496008264 |
NPI Enumeration Date: | 09/24/2007 |
NPI Last Update Date: | 08/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A50052 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |