Healthcare Provider Details

I. General information

NPI: 1962625202
Provider Name (Legal Business Name): ST. JOSEPH HOSPITAL OF ORANGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

353 S MAIN ST
ORANGE CA
92868-3833
US

IV. Provider business mailing address

353 S MAIN ST
ORANGE CA
92868-3833
US

V. Phone/Fax

Practice location:
  • Phone: 714-771-8006
  • Fax: 714-744-8630
Mailing address:
  • Phone: 714-771-8006
  • Fax: 714-744-8630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. ALAN H GARRETT
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 714-771-8000