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Organization
NORTH ORANG COUNTY PEDIATRICS CHILES DAN W ET AL GEN PTRS
Active
Organization
NORTH ORANG COUNTY PEDIATRICS CHILES DAN W ET AL GEN PTRS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES J BACHA MD (PHYSICIAN)
(714) 528-5112
Entity
Organization
Contact information
Practice address
895 E YORBA LINDA BLVD, SUITE 101, PLACENTIA, CA 92870-3695
(714) 528-5112
(714) 996-9355
Mailing address
895 E YORBA LINDA BLVD, SUITE 101, PLACENTIA, CA 92870-3695
(714) 528-5112
(714) 996-9355
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
A23480
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A21067
MEDICAL LIC NUMBER
CA
01
—
A23480
MEDICAL LIC NUMBER
CA
01
—
A26098
MEDICAL LIC NUMBER
CA
05
—
GR0024380
—
CA
05
—
GR0040180
—
CA
Enumeration date
11/08/2007
Last updated
02/28/2013
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