Healthcare Provider Details

I. General information

NPI: 1194974402
Provider Name (Legal Business Name): NORTH ORANGE COUNTY REGIONAL HEALTH FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2008
Last Update Date: 09/27/2022
Certification Date: 09/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1182 N EUCLID ST
ANAHEIM CA
92801-1900
US

IV. Provider business mailing address

1182 N EUCLID ST
ANAHEIM CA
92801-1900
US

V. Phone/Fax

Practice location:
  • Phone: 714-441-0411
  • Fax: 714-441-1824
Mailing address:
  • Phone: 714-441-0411
  • Fax: 714-441-1824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number550000830
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1194974402
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number1194974402
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: ROCIO MAGDALENO
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 657-276-7603