| Bristol Park Medical Group, Inc. | |
|
1212 W 17th St Santa Ana CA 92706-3418 | |
| (714) 954-0432 | |
| (714) 796-6265 |
| Full Name | Bristol Park Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 1212 W 17th St, Santa Ana, California |
| Authorized Official Name and Position | Mark D Schafer (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7146651661 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bristol Park Medical Group, Inc. 2742 Dow Ave Tustin CA 92780-7242 Ph: (714) 665-1600 | Bristol Park Medical Group, Inc. 1212 W 17th St Santa Ana CA 92706-3418 Ph: (714) 954-0432 |
| NPI Number | 1275580995 |
|---|---|
| Provider Enumeration Date | 05/28/2006 |
| Last Update Date | 10/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275580995 | NPI | - | NPPES |
| GR006919H | Medicaid | CA |
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