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General NPI Number Information
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NPI Number | 1356763148
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Entity Type | Organization
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Legal Business Name | ORANGE COUNTY HEALTH CARE AGENCY
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Dates
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Enumeration Date | 01/13/2014
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Last Update Date | 01/13/2014
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Provider Practice Location Address
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Address Line | 1200 N MAIN ST STE 300
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City | SANTA ANA
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State | CA
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Zip | 92701-3625
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Country | US
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Telephone | 714-580-6755
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Fax |
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Provider Business Mailing Address
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Address Line | 3201 YORBA LINDA BLVD
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City | FULLERTON
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State | CA
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Zip | 92831-1755
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SERVICE CHIEF 2
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Name | MICHAEL ZIPPWALD
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Credential |
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Telephone | 714-480-4653
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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