Healthcare Provider Details

I. General information

NPI: 1134466642
Provider Name (Legal Business Name): FIRST CHOICE PHYSICIAN PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2013
Last Update Date: 06/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 N ROSE DR STE 210
PLACENTIA CA
92870-3800
US

IV. Provider business mailing address

1325 N ROSE DR STE 210
PLACENTIA CA
92870-3800
US

V. Phone/Fax

Practice location:
  • Phone: 714-961-5804
  • Fax: 714-961-5809
Mailing address:
  • Phone: 714-961-5804
  • Fax: 714-961-5809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFF KOURY
Title or Position: SVP REGIONAL OPERATIONS, TENET
Credential:
Phone: 714-428-6842