Healthcare Provider Details

I. General information

NPI: 1982927877
Provider Name (Legal Business Name): HOAG ORTHOPEDIC INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2010
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16250 SAND CANYON AVENUE
IRVINE CA
92618-3714
US

IV. Provider business mailing address

16250 SAND CANYON AVE
IRVINE CA
92618-3714
US

V. Phone/Fax

Practice location:
  • Phone: 949-764-1884
  • Fax:
Mailing address:
  • Phone: 949-517-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number StateCA

VIII. Authorized Official

Name: KIM MIKES
Title or Position: SENIOR VICE PRESIDENT & CEO
Credential:
Phone: 949-517-3149