1861098287 NPI number — ORTHOPAEDIC REHABILITATION CLINICIANS AND ASSOCIATES PC

Table of content: ANNIE WAN BISHAI M.D. (NPI 1164666897)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861098287 NPI number — ORTHOPAEDIC REHABILITATION CLINICIANS AND ASSOCIATES PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHOPAEDIC REHABILITATION CLINICIANS AND ASSOCIATES PC
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:
Provider Other Organization Name Type Code:
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:
1861098287
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/10/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5 HOLLAND
Provider Second Line Business Mailing Address:
#101
Provider Business Mailing Address City Name:
IRVINE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92618-2598
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-588-2190
Provider Business Mailing Address Fax Number:
949-588-2199

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1120 WEST LA VETA AVENUE
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
ORANGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92868-4246
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-855-3671
Provider Business Practice Location Address Fax Number:
714-941-9539
Provider Enumeration Date:
12/10/2020

Additional Information

Authorized Official

Authorized Official Last Name:
CHANG
Authorized Official First Name:
ERIC
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
949-588-2190

Provider Taxonomy Codes

  • Taxonomy code: 2081P2900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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