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General NPI Number Information
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NPI Number | 1801763990
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Entity Type | Organization
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Legal Business Name | CPSC PROVIDER SERVICES CORP
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Dates
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Enumeration Date | 10/22/2025
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 5562 PHILADELPHIA ST STE 111
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City | CHINO
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State | CA
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Zip | 91710-2482
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Country | US
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Telephone | 909-517-0000
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Fax | 909-517-9158
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Provider Business Mailing Address
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Address Line | 5562 PHILADELPHIA ST STE 111
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City | CHINO
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State | CA
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Zip | 91710-2482
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Country | US
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Telephone | 909-517-0000
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Fax | 909-517-9158
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. HARRY OU
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Credential | MD
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Telephone | 909-517-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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