Healthcare Provider Details

I. General information

NPI: 1154336949
Provider Name (Legal Business Name): ORANGE COUNTY THORACIC AND CARDIOVASCULAR SURGEONS A MED CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 W STEWART DR SUITE 503
ORANGE CA
92868-3854
US

IV. Provider business mailing address

1310 W STEWART DR SUITE 503
ORANGE CA
92868-3854
US

V. Phone/Fax

Practice location:
  • Phone: 714-997-2224
  • Fax: 714-997-1187
Mailing address:
  • Phone: 714-997-2224
  • Fax: 714-997-1187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. BRIAN AVECILLA PALAFOX
Title or Position: PRESIDENT
Credential: M.D.
Phone: 714-997-2224