Basic Information
| Provider Information | |||||||||
| NPI: | 1982655304 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AHEARN | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7087 | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928637087 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145715000 | ||||||||
| FaxNumber: | 7145715055 | ||||||||
| Practice Location | |||||||||
| Address1: | 30230 RANCHO VIEJO RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SAN JUAN CAPISTRANO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926751557 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9494434303 | ||||||||
| FaxNumber: | 9494434033 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2006 | ||||||||
| LastUpdateDate: | 04/16/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | G54979 | CA | N | Other Service Providers | Specialist | 207R00000X | G54979 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.