MEDICARE: PLANNED PARENTHOOD/ORANGE AND SAN BERNARDINO COUNTIES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	240000770	CA
2	261Q00000X	Clinic/Center		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	05D0666696	OTHER	CA	CLIA ORANGE
2	05D1042218	OTHER	CA	CLIA WESTMINSTER LAB
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	CMM70867F	OTHER	CA	CLINIC/CENTER

General Provider Information

NPI Number	:	1003885518
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLANNED PARENTHOOD/ORANGE AND SAN BERNARDINO COUNTIES INC.

Provider Business Mailing Address
First Line	:	801 E KATELLA AVE
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92805-6614
Country	:	US
Telephone Number	:	714-633-3736
Fax Number	:	714-532-2929

Provider Business Practice Location Address
First Line	:	1873 COMMERCE CENTER WEST
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92408-3303
Country	:	US
Telephone Number	:	909-890-5511
Fax Number	:	909-890-4599

Authorized Official
Title or Position	:	VP OF FINANCE
Name	:	JESSICA CHINEN
Credential	:
Telephone Number	:	714-633-6373

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	10/20/2021

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Directions to “PLANNED PARENTHOOD/ORANGE AND SAN BERNARDINO COUNTIES INC. ” Practice Location

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