Healthcare Provider Details

I. General information

NPI: 1396798690
Provider Name (Legal Business Name): ACUTE CARE MEDICAL GROUP OF ORANGE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 E CHAPMAN AVE
ORANGE CA
92869-3206
US

IV. Provider business mailing address

PO BOX 2035
ORANGE CA
92859-0035
US

V. Phone/Fax

Practice location:
  • Phone: 714-633-0011
  • Fax:
Mailing address:
  • Phone: 562-809-3569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PETER G ANDERSON
Title or Position: PRESIDENT
Credential: MD
Phone: 562-809-3569