Organization
CHILDREN'S HOSPITAL OF ORANGE COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VIVIAN DERR PNP (MANAGER OUTREACH CLINICS)
(714) 289-4812
Entity
Organization
Contact information
Practice address
406 S MAIN ST, SANTA ANA, CA 92701-5712
(714) 289-4800
Mailing address
1314 VISTA PRADO, SAN CLEMENTE, CA 92673-3649
(714) 997-3000
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
546154
CA
Other
Enumeration date
11/23/2005
Last updated
08/22/2020
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