Organization
ORANGE HILLS MEDICAL GROUP
Active
Other names
Orange Hills Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LICEAGA RN (ADMINISTRATOR)
(714) 770-8366
Entity
Organization
Contact information
Practice address
1520 E LINCOLN AVE, ORANGE, CA 92865-1928
(714) 770-8350
Mailing address
295 IMPERIAL HWY, FULLERTON, CA 92835-1020
(714) 770-8300
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
—
CA
208VP0014X
Interventional Pain Medicine Physician
—
CA
Other
Enumeration date
04/17/2013
Last updated
04/17/2013
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