Healthcare Provider Details

I. General information

NPI: 1497185177
Provider Name (Legal Business Name): CHOC CHILDREN'S HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2013
Last Update Date: 11/18/2013
Certification Date:
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 S. LA VETA AVENUE
ORANGE CA
92868
US

V. Phone/Fax

Practice location:
  • Phone: 714-509-8624
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: PATTY SCHRIVER
Title or Position: CLINICAL MANAGER
Credential: MSN, MHA, RN, CCRN
Phone: 714-509-8624