Organization
OCIGE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AHMAD M SHABAN M.D. (MEDICAL DIRECTOR - OWNER)
(949) 364-2611
Entity
Organization
Contact information
Practice address
26732 CROWN VALLEY PKWY, SUITE 241, MISSION VIEJO, CA 92691-6306
(949) 364-2611
(949) 364-0226
Mailing address
26732 CROWN VALLEY PKWY, SUITE 241, MISSION VIEJO, CA 92691-6306
(949) 364-2611
(949) 364-0226
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
060000405
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0869549
CLIA
CA
01
—
060000405
DHS STATE LICENSE
CA
01
—
FNP34251
MEDICAL BOARD FICTITIOUS
CA
Enumeration date
01/15/2007
Last updated
06/07/2012
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