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NPI Code Detail

MEDICARE: ORANGE COUNTY UROLOGY ASSOCIATES, INC. A MEDICAL GROUP

MEDICARE: ORANGE COUNTY UROLOGY ASSOCIATES, INC. A MEDICAL GROUP
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
1363LA2100XAcute Care Nurse Practitioner
2363AM0700XMedical Physician Assistant
32088F0040XUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
4363A00000XPhysician Assistant
52085R0204XVascular & Interventional Radiology Physician
6363L00000XNurse Practitioner
7208800000XUrology Physician

General Provider Information

NPI Number : 1215992748
Entity Type Code : Organization
Provider Name (Legal Business Name) : ORANGE COUNTY UROLOGY ASSOCIATES, INC. A MEDICAL GROUP
Provider Business Mailing Address
First Line : 23961 CALLE DE LA MAGDALENA STE 500
Second Line :
City : LAGUNA HILLS
State : CA
Zip : 92653-7622
Country : US
Telephone Number : 949-855-1101
Fax Number : 949-289-9171
Provider Business Practice Location Address
First Line : 23961 CALLE DE LA MAGDALENA STE 500
Second Line :
City : LAGUNA HILLS
State : CA
Zip : 92653-7622
Country : US
Telephone Number : 949-855-1101
Fax Number : 949-855-8710
Authorized Official
Title or Position : PRESIDENT
Name : MOSES M KIM
Credential : MD
Telephone Number : 949-855-1101
Provider Enumeration Date : 04/18/2006
Last Update Date : 04/21/2026

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Practice Location Address:
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