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NPI Code Detail

MEDICARE: CHILDRENS HOSPITAL OF ORANGE COUNTY

MEDICARE: CHILDRENS 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
1261QP2300XPrimary Care Clinic/CenterCMM71081FCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CMM71081FOTHERCAGROUP MEDI-CAL ID NUMBER

General Provider Information

NPI Number : 1528195716
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHILDRENS HOSPITAL OF ORANGE COUNTY
Provider Business Mailing Address
First Line : 136 BROADWAY
Second Line :
City : COSTA MESA
State : CA
Zip : 92627-2818
Country : US
Telephone Number : 714-589-4861
Fax Number :
Provider Business Practice Location Address
First Line : 136 BROADWAY
Second Line :
City : COSTA MESA
State : CA
Zip : 92627-2818
Country : US
Telephone Number : 714-589-4861
Fax Number :
Authorized Official
Title or Position : BILLING MANAGER
Name : MRS. GINA SUE CADOGAN
Credential : C.P.C.
Telephone Number : 714-289-4818
Provider Enumeration Date : 02/27/2007
Last Update Date : 08/22/2020

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Directions to “CHILDRENS HOSPITAL OF ORANGE COUNTY ” Practice Location

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