# CHILDREN'S HOSPITAL OF ORANGE COUNTY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CHILDREN'S HOSPITAL OF ORANGE COUNTY
- **Other names:** CS Cardiothoracic Surgery
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1164882999
- **Legal business name:** CHILDREN'S HOSPITAL OF ORANGE COUNTY
- **Authorized official:** MARK KELLY (DIRECTOR REVENUE CYCLE SUPPORT)
- **Authorized official phone:** (714) 509-7861

## Contact information

- **Practice address:** 1201 W LA VETA AVE, ORANGE, CA 92868-4203
- **Practice address phone:** (714) 509-8649
- **Practice address fax:** (714) 509-8374
- **Mailing address:** 1201 W LA VETA AVE, ORANGE, CA 92868-4203
- **Mailing address phone:** (714) 509-8649
- **Mailing address fax:** (714) 509-8374

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0000X | Cardiovascular Disease Physician | — | CA | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | CA | Yes |

## Other

- **Enumeration date:** 03/07/2016
- **Last updated:** 04/06/2016