Healthcare Provider Details

I. General information

NPI: 1205040649
Provider Name (Legal Business Name): HOAG HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOAG DR
NEWPORT BEACH CA
92663-4162
US

IV. Provider business mailing address

3 BOTTLEBRUSH
ALISO VIEJO CA
92656-2121
US

V. Phone/Fax

Practice location:
  • Phone: 949-764-4624
  • Fax:
Mailing address:
  • Phone: 949-246-0311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number596361
License Number StateCA

VIII. Authorized Official

Name: MRS. BARBARA EVELYN RITTER
Title or Position: REGISTERED NURSE
Credential: R.N.
Phone: 949-764-5661