Registry details
Type
Individual
Primary specialty
Anesthesiology
Enumerated
Oct 18, 2007
License(s)
ME112932 (FL), D76955 (MD), A137806 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 200 PARIS LN APT 109 | Newport Beach, CA 92663-1600 | 305-333-4464 |
| LOCATION | 200 PARIS LN APT 109 | Newport Beach, CA 92663-1600 | 305-333-4464 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.