Theodore Vandam M.D.

LBN: Theodore Vandam M.D.
Theodore Vandam M.D. is an health care organization with primary practice located at 665 Camino De Los Mares Ste 210, San Clemente CA 92673-2859. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Theodore Vandam M.D. can be contacted via phone (949) 240-6772, or through Vandam, Theodore via phone (949) 240-6772.

Contact Information

Primary practice address
665 Camino De Los Mares Ste 210 San Clemente CA 92673-2859
Phone: (949) 240-6772
Fax: (949) 240-6841
Website:
Map and Directions
Authorized official contact:
Name: Vandam, Theodore Doctor of Medicine (MD)
Phone: (949) 240-6772

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X A24788 California

Profile Details

NPI number 1699978304
LBN Legal business name Theodore Vandam M.D.
DBA Doing business as
Authorized official Vandam, Theodore Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 8th, 2007
Last updated Jul 28th, 2010 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699978304 NPPES
California MEDICAID 00A247880

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