GEORGE O. DETARNOWSKY, JR M.D., INC. – NPI #1912176728
Clinic/Center

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

Health Care Provider Taxonomy Code for Clinic/Center

GEORGE O. DETARNOWSKY, JR M.D., INC. is an AHC clinic located in NEWPORT BEACH, CA. NPPES has assigned the NPI number 1912176728 to GEORGE O. DETARNOWSKY, JR M.D., INC. on February 26, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QM2500X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Medical Specialty

The NPI profile was previously updated about 18 years ago on Oct 21, 2008. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GEORGE O. DETARNOWSKY, JR M.D., INC. below.

NPI Profile for
GEORGE O. DETARNOWSKY, JR M.D., INC.

NPI Number
1912176728
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GEORGE O. DETARNOWSKY, JR M.D., INC.
Primary location
355 PLACENTIA AVE
SUITE 300
NEWPORT BEACH, CA 92663-3311
Phone: (949) 574-5026 Fax: (949) 548-8893
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
GEORGE DETARNOWSKY
OWNER
Phone: (949) 574-5026
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM2500X
- Clinic/Center / Medical Specialty (Primary)		 CA G41113
305R00000X
- Preferred Provider Organization		 CA G41113

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.