# 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 Craniofacial
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1629616792
- **Legal business name:** CHILDREN'S HOSPITAL OF ORANGE COUNTY
- **Authorized official:** KERRI RUPPERT SCHILLER (EXECUTIVE VICE PRESIDENT & CFO)
- **Authorized official phone:** (714) 509-8451

## Contact information

- **Practice address:** 1201 W LA VETA AVE, ORANGE, CA 92868-4203
- **Practice address phone:** (888) 770-2462
- **Practice address fax:** (855) 246-2329
- **Mailing address:** 1201 W LA VETA AVE, ORANGE, CA 92868-4203

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | — |
| 122300000X | Dentist | — | — | — |
| 1223P0221X | Pediatric Dentistry | — | NULL | — |
| 1223P0221X | Pediatric Dentistry | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 12/19/2019
- **Last updated:** 11/30/2020