MEDICARE: CHILDREN'S HOSPITAL OF ORANGE COUNTY

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	282NC2000X	Children's Hospital		CA

General Provider Information

NPI Number	:	1225419302
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDREN'S HOSPITAL OF ORANGE COUNTY

Provider Business Mailing Address
First Line	:	1120 W LA VETA AVE STE 470
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92868-4233
Country	:	US
Telephone Number	:	714-509-8481
Fax Number	:	714-509-4374

Provider Business Practice Location Address
First Line	:	1120 W LA VETA AVE STE 470
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92868-4233
Country	:	US
Telephone Number	:	714-509-8481
Fax Number	:	714-509-4374

Authorized Official
Title or Position	:	CHIEF MEDICAL OFFICER AND VICE PRES
Name	:	DR. MARIA MINON
Credential	:	MD
Telephone Number	:	714-509-8413

Provider Enumeration Date	:	06/15/2015
Last Update Date	:	07/23/2015

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Directions to “CHILDREN'S HOSPITAL OF ORANGE COUNTY ” Practice Location

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