Healthcare Provider Details

I. General information

NPI: 1689864365
Provider Name (Legal Business Name): HOAG HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2007
Last Update Date: 07/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 CORPORATE PLAZA DR SUITE 150
NEWPORT BEACH CA
92660-7985
US

IV. Provider business mailing address

60 ELKSFORD AVE
IRVINE CA
92604-2452
US

V. Phone/Fax

Practice location:
  • Phone: 949-515-0708
  • Fax:
Mailing address:
  • Phone: 949-653-0252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number444573
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number444573
License Number StateCA

VIII. Authorized Official

Name: MISS JOYCE E. ANDERSON
Title or Position: RN
Credential: RNFA
Phone: 949-515-0708