Organization Name: | AQUAPHIRE INC |
NPI Number: | 1861862385 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHELLE CATHLEEN HURE (PRESIDENT) |
Mailing Address: | 31899 Del Obispo St Suite 130 San Juan Capistrano |
State: | CA US |
Postal Code: | 926753234 |
Phone Number: | 9493596400 |
Fax Number: | |
NPI Enumeration Date: | 09/26/2015 |
NPI Last Update Date: | 11/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A112182 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |