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Organization
PEDIATRIC SUBSPECIALTY FACULTY, INC.
Active
Organization
PEDIATRIC SUBSPECIALTY FACULTY, INC.
Active
Other names
CHOC Pediatric Subspecialty Faculty
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HALE KUHLMAN (EXECUTIVE DIRECTOR)
(714) 532-8649
Entity
Organization
Contact information
Practice address
1201 W LA VETA AVE, ORANGE, CA 92868-4203
(714) 509-8649
(714) 509-8374
Mailing address
455 S MAIN ST, ORANGE, CA 92868-3835
(715) 094-8649
(714) 509-8374
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003054420
—
CA
05
—
1093905051
—
CA
05
—
1144468620
—
CA
05
—
1194915157
—
CA
05
—
1265673743
—
CA
05
—
1306098652
—
CA
05
—
1356531313
—
CA
05
—
1356531321
—
CA
05
—
1386834349
—
CA
05
—
1447440409
—
CA
05
—
1447440417
—
CA
05
—
1467642421
—
CA
05
—
1538359591
—
CA
05
—
1639310113
—
CA
05
—
1679714844
—
CA
05
—
1740470707
—
CA
05
—
1801086871
—
CA
05
—
1811187875
—
CA
05
—
1902096969
—
CA
01
—
ZZZ079907
BLUE SHIELD/1201
CA
01
—
ZZZ08133Z
BLUE SHIELD/1120
CA
01
—
ZZZ08568Z
BLUE SHIELD/1310
CA
01
—
ZZZ411188Z
BLUE SHIELD/455
CA
Enumeration date
11/21/2006
Last updated
07/21/2022
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