MEDICARE: ORANGE COAST MEDICAL 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	332B00000X	Durable Medical Equipment & Medical Supplies	C2603168	CA

General Provider Information

NPI Number	:	1093088866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORANGE COAST MEDICAL INC.

Provider Business Mailing Address
First Line	:	12062 VALLEY VIEW ST STE 125
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92845-1741
Country	:	US
Telephone Number	:	714-892-7205
Fax Number	:	714-892-7059

Provider Business Practice Location Address
First Line	:	12062 VALLEY VIEW ST STE 125
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92845-1741
Country	:	US
Telephone Number	:	714-892-7205
Fax Number	:	714-892-7059

Authorized Official
Title or Position	:	OWNER
Name	:	PATRICIA PINON
Credential	:
Telephone Number	:	714-892-7205

Provider Enumeration Date	:	02/09/2012
Last Update Date	:	02/09/2012

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