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	261QU0200X	Urgent Care Clinic/Center
2	282NC2000X	Children's Hospital

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3253	OTHER	CA	BLUE CROSS
3	0001	OTHER	CA	CHAMPUS
4	CHOC	OTHER	CA	UNIVERSAL CARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	ZZZD3004Z	OTHER	CA	BLUE SHIELD

General Provider Information

NPI Number	:	1811080526
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDREN'S HOSPITAL OF ORANGE COUNTY

Provider Business Mailing Address
First Line	:	1201 W LA VETA AVE
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92868-4203
Country	:	US
Telephone Number	:	714-997-3000
Fax Number	:	714-532-8753

Provider Business Practice Location Address
First Line	:	1201 W LA VETA AVE
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92868-4203
Country	:	US
Telephone Number	:	714-997-3000
Fax Number	:	714-532-8753

Authorized Official
Title or Position	:	SR. VICE PRESIDENT MEDICAL AFFAIRS
Name	:	DR. SANDIP GODAMBE
Credential	:	MD
Telephone Number	:	714-509-8413

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	10/24/2025

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

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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