MEDICARE: OCCRSC 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	174400000X	Specialist	A55079	CA

General Provider Information

NPI Number	:	1619318730
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCCRSC INC

Provider Business Mailing Address
First Line	:	19121 BROOKHURST ST STE 201
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92646-2545
Country	:	US
Telephone Number	:	714-444-4011
Fax Number	:	714-444-2668

Provider Business Practice Location Address
First Line	:	19121 BROOKHURST ST STE 203
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92646-2545
Country	:	US
Telephone Number	:	714-444-4011
Fax Number	:	714-444-2668

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THUAN T NGUYEN
Credential	:	M.D.
Telephone Number	:	714-444-4011

Provider Enumeration Date	:	07/17/2013
Last Update Date	:	01/15/2025

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