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General NPI Number Information
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NPI Number | 1841324522
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Entity Type | Organization
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Legal Business Name | ORANGE COUNTY PHYSICIANS REFERENCE LAB, INC
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 720 N TUSTIN AVE SUITE 105
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City | SANTA ANA
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State | CA
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Zip | 92705-3606
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Country | US
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Telephone | 714-321-5747
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Fax | 714-542-1708
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Provider Business Mailing Address
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Address Line | 720 N TUSTIN AVE SUITE 105
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City | SANTA ANA
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State | CA
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Zip | 92705-3606
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Country | US
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Telephone | 714-321-5747
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Fax | 714-542-1708
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Authorized Official
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Title or Position | OWNER
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Name | MR. PETER ERNEST MUNCHHEIMER
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Credential |
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Telephone | 714-321-5747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | CLF334424
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License Number State | CA
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