Bristol Park Medical Group, Inc
LBN: Bristol Park Medical Group, Inc
Bristol Park Medical Group, Inc is an health care organization with primary practice located at 2742 Dow Ave , Tustin CA 92780-7242. The organization recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics, Managed Care Organizations / Exclusive Provider Organization, Suppliers / Durable Medical Equipment & Medical Supplies. Managed Care Organizations / Exclusive Provider Organization is the primary health care specialty.
Bristol Park Medical Group, Inc can be contacted via phone (714) 665-1661, or through Schafer, Mark D via phone (714) 665-1661.
Contact Information
Primary practice address
2742 Dow Ave
Tustin CA 92780-7242
Phone: (714) 665-1661
Fax: (714) 665-1669
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ||
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ||
| Managed Care Organizations / Exclusive Provider Organization | 302F00000X | ||
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X |
Profile Details
| NPI number | 1548348113 |
|---|---|
| LBN Legal business name | Bristol Park Medical Group, Inc |
| DBA Doing business as | |
| Authorized official | Schafer, Mark D Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 1st, 2006 |
| Last updated | Oct 15th, 2008 - about 18 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548348113 | NPPES |
| California | MEDICAID | GR0069197 | |
| California | MEDICAID | GR006919J | |
| California | MEDICAID | GR006919A | |
| California | MEDICAID | GR006919H | |
| California | MEDICAID | GR0069190 | |
| California | MEDICAID | GR0069196 | |
| California | MEDICAID | GR0069198 | |
| California | MEDICAID | GR006919G | |
| California | MEDICAID | GR0069199 | |
| California | MEDICAID | GR006919B | |
| California | MEDICAID | GR0069194 |
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