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NPI Code Detail

MEDICARE: OCCUPATIONAL HEALTH CENTERS OF CALIFORNIA, A MEDICAL CORPORATION

MEDICARE: OCCUPATIONAL HEALTH CENTERS OF CALIFORNIA, A MEDICAL CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QH0100XHealth Service Clinic/Center
2261QP2000XPhysical Therapy Clinic/Center
3261QX0100XOccupational Medicine Clinic/Center

General Provider Information

NPI Number : 1639646805
Entity Type Code : Organization
Provider Name (Legal Business Name) : OCCUPATIONAL HEALTH CENTERS OF CALIFORNIA, A MEDICAL CORPORATION
Provider Business Mailing Address
First Line : 5080 SPECTRUM DR STE 1200W
Second Line :
City : ADDISON
State : TX
Zip : 75001-4624
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3200 INLAND EMPIRE BLVD STE 100
Second Line :
City : ONTARIO
State : CA
Zip : 91764-5569
Country : US
Telephone Number : 909-945-5011
Fax Number : 909-989-6158
Authorized Official
Title or Position : VP
Name : JOHN ANDERSON
Credential : DO
Telephone Number : 972-364-8000
Provider Enumeration Date : 10/25/2018
Last Update Date : 06/19/2025

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