Healthcare Provider Details

I. General information

NPI: 1225324932
Provider Name (Legal Business Name): ORANGE COUNTY PHYSICIANS IPA MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2011
Last Update Date: 01/28/2022
Certification Date: 01/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5785 CORPORATE AVE.
CYPRESS CA
90630-4726
US

IV. Provider business mailing address

P.O. BOX 6300
CYPRESS CA
90630-0063
US

V. Phone/Fax

Practice location:
  • Phone: 714-947-8600
  • Fax: 714-947-8799
Mailing address:
  • Phone: 714-947-8600
  • Fax: 714-947-8799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: DR. JACOB SWEIDAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 714-947-8600