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General NPI Number Information
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NPI Number | 1629864665
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Entity Type | Organization
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Legal Business Name | CHILDREN'S HOSPITAL OF ORANGE COUNTY
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Dates
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Enumeration Date | 04/16/2025
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 5665 ALTON PKWY STE 300
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City | IRVINE
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State | CA
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Zip | 92618-4059
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Country | US
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Telephone | 949-898-6020
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Fax | 949-898-6021
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Provider Business Mailing Address
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Address Line | 1201 W LA VETA AVE
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City | ORANGE
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State | CA
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Zip | 92868-4203
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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 | CREDENTIALING MANAGER
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Name | ZENICEL J. GONZALES
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Credential |
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Telephone | 714-509-4511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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