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NPI Code Detail

MEDICARE: DR. OSCAR OO PSY.D.

MEDICARE:  DR. OSCAR  OO  PSY.D.
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
1103TC0700XClinical PsychologistPSY22699CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CS098AOTHERCAMEDICARE PTAN

General Provider Information

NPI Number : 1427128156
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. OSCAR OO PSY.D.
Provider Business Mailing Address
First Line : 4000 MACARTHUR BLVD
Second Line : SUITE 600, EAST TOWER
City : NEWPORT BEACH
State : CA
Zip : 92660-2558
Country : US
Telephone Number : 949-648-3704
Fax Number : 714-352-6471
Provider Business Practice Location Address
First Line : 4000 MACARTHUR BLVD
Second Line : SUITE 600, EAST TOWER
City : NEWPORT BEACH
State : CA
Zip : 92660-2558
Country : US
Telephone Number : 949-648-3704
Fax Number : 714-352-6471
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2006
Last Update Date : 01/11/2017

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