Healthcare Provider Details

I. General information

NPI: 1164686879
Provider Name (Legal Business Name): CHILDRENS HOSPITAL OF ORANGE COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2008
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 S MAIN ST
ORANGE CA
92868-3835
US

IV. Provider business mailing address

1201 W LA VETA AVE
ORANGE CA
92868-4203
US

V. Phone/Fax

Practice location:
  • Phone: 714-532-8334
  • Fax: 714-516-4371
Mailing address:
  • Phone: 714-532-8334
  • Fax: 714-516-4371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number
License Number State

VIII. Authorized Official

Name: KERRI RUPPERT SCHILLER
Title or Position: EXECUTIVE VP AND CFO
Credential:
Phone: 714-509-8451