Healthcare Provider Details

I. General information

NPI: 1083966691
Provider Name (Legal Business Name): FIRST CHOICE PHYSICIAN PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2012
Last Update Date: 06/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S ANAHEIM HILLS RD STE 242
ANAHEIM CA
92807-4780
US

IV. Provider business mailing address

500 S ANAHEIM HILLS RD STE 242
ANAHEIM CA
92807-4780
US

V. Phone/Fax

Practice location:
  • Phone: 714-974-0611
  • Fax: 714-221-2345
Mailing address:
  • Phone: 714-974-0611
  • Fax: 714-221-2345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFF KOURY
Title or Position: SVP REGIONAL OPERATIONS, TENET
Credential:
Phone: 714-428-6842