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Organization
ORANGE COUNTY THORACIC AND CARDIOVASCULAR SURGEONS A MED CORP
Active
Organization
ORANGE COUNTY THORACIC AND CARDIOVASCULAR SURGEONS A MED CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN AVECILLA PALAFOX M.D. (PRESIDENT)
(714) 997-2224
Entity
Organization
Contact information
Practice address
1310 W STEWART DR, SUITE 503, ORANGE, CA 92868-3854
(714) 997-2224
(714) 997-1187
Mailing address
1310 W STEWART DR, SUITE 503, ORANGE, CA 92868-3854
(714) 997-2224
(714) 997-1187
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR0063480
GROUP MEDI-CAL NUMBER
CA
01
—
W13353
MEDICARE PTAN
—
Enumeration date
07/30/2006
Last updated
05/20/2024
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