Breakwater Medical Group LLC
NPI #1497019111 in Costa Mesa, California
Provider Information
- NPI Number
- 1497019111
- Entity Type
- Organization
- Organization Name
- Breakwater Medical Group LLC
- Primary Specialty
- Clinical Medical Laboratory
- Enumeration Date
- Jun 27, 2012
- Last Updated
- Jun 27, 2012
Practice Location
- Address
- 357 VICTORIA ST
- Address 2
- SUITE 2
- City
- Costa Mesa
- State
- California
- ZIP Code
- 92627-1931
- Phone
- (949) 903-1053
Authorized Official
- Name
- MATT LUCHINI
- Title
- ACCOUNTS MANAGER
- Phone
- (928) 533-4220
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinical Medical Laboratory |
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