Provider Demographics
NPI:1902601503
Name:CREATIVE MEDICAL SERVICES INC
Entity type:Organization
Organization Name:CREATIVE MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:WILCHEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-221-4169
Mailing Address - Street 1:1901 NEWPORT BLVD STE 350
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-2299
Mailing Address - Country:US
Mailing Address - Phone:833-221-4169
Mailing Address - Fax:
Practice Address - Street 1:1901 NEWPORT BLVD STE 350
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-2299
Practice Address - Country:US
Practice Address - Phone:833-221-4169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty