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Organization
CHILDREN'S HOSPITAL OF ORANGE COUNTY
Active
Organization
CHILDREN'S HOSPITAL OF ORANGE COUNTY
Active
Parent organization
CHILDREN'S HOSPITAL OF ORANGE COUNTY
Other names
CS Miscellaneous Physician Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN'S HOSPITAL OF ORANGE COUNTY
Authorized official
MARK KELLY (DIRECTOR, BUSINESS SERVICES)
(714) 509-7964
Entity
Organization
Contact information
Practice address
1201 W LA VETA AVE, ORANGE, CA 92868-4203
(714) 509-8649
(714) 509-8374
Mailing address
1201 W LA VETA AVE, ORANGE, CA 92868-4203
(714) 509-8649
(714) 509-8374
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
CA
103TC0700X
Clinical Psychologist
—
CA
103TC2200X
Clinical Child & Adolescent Psychologist
—
CA
202C00000X
Independent Medical Examiner Physician
—
CA
208000000X
Pediatrics Physician
—
CA
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
—
CA
2084P0800X
Psychiatry Physician
—
CA
2084P0804X
Child & Adolescent Psychiatry Physician
—
CA
Other
Enumeration date
03/17/2015
Last updated
03/23/2015
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