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Bristol Park Medical Group — NPI 1881736445, Costa Mesa, CA | NPI Central

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NPI 1881736445

OrganizationActive

Bristol Park Medical Group

NPI 1881736445 · Non-Pharmacy Dispensing Site · Costa Mesa, CA

Provider details

NPI number: 1881736445
Entity type: Organization
Primary specialty: Non-Pharmacy Dispensing SiteSuppliers
Parent organization: Medvantx, Inc.
Authorized official: Kenny Heine, Director of Operations
License: A87971 (CA)

Practice location

722 Baker St

Costa Mesa, CA 92626-4320

Phone: (714) 557-6300

More CA providers

Mailing address

5810 Nancy Ridge Dr

San Diego, CA 92121-2834

Registry dates

Enumerated: 2007-02-12
Last updated: 2009-05-29

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.