Healthcare Provider Details
I. General information
NPI: 1114809241
Provider Name (Legal Business Name): CHILDREN'S HOSPITAL OF ORANGE COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/21/2025
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1201 W LA VETA AVE
ORANGE CA
92868-4203
US
IV. Provider business mailing address
1201 W LA VETA AVE
ORANGE CA
92868-4203
US
V. Phone/Fax
- Phone: 888-457-1362
- Fax: 844-387-7625
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XP3100X |
| Taxonomy | Pediatric Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XS0106X |
| Taxonomy | Orthopaedic Hand Surgery Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XS0117X |
| Taxonomy | Orthopaedic Surgery of the Spine Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XX0004X |
| Taxonomy | Orthopaedic Foot and Ankle Surgery Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XX0005X |
| Taxonomy | Sports Medicine (Orthopaedic Surgery) Physician |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XX0801X |
| Taxonomy | Orthopaedic Trauma Physician |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
ULI
JR.
Title or Position: CFO
Credential:
Phone: 858-966-5907