1265709414 NPI number — ORANGE COUNTY HEALTHCARE INC

Table of content: (NPI 1265709414)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265709414 NPI number — ORANGE COUNTY HEALTHCARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORANGE COUNTY HEALTHCARE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CA FAMILY MEDICAL CENTER & URGENT CARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265709414
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/02/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9918 KATELLA AVE STE C
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANAHEIM
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92804-6466
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-625-8320
Provider Business Mailing Address Fax Number:
657-999-6396

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9918 KATELLA AVE
Provider Second Line Business Practice Location Address:
STE C
Provider Business Practice Location Address City Name:
ANAHEIM
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92804-6465
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-625-8320
Provider Business Practice Location Address Fax Number:
714-583-7660
Provider Enumeration Date:
11/16/2011

Additional Information

Authorized Official

Authorized Official Last Name:
KILANI
Authorized Official First Name:
SUHEIR
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
714-625-8320

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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