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Organization

CHILDREN'S HOSPITAL OF ORANGE COUNTY

Active
Parent organization
CHILDREN'S HOSPITAL OF ORANGE COUNTY
Other names
CHOC Primary Care Network
Organization subpart
Yes

Provider details

NPI number
Legal business name
CHILDREN'S HOSPITAL OF ORANGE COUNTY
Authorized official
MARK KELLY (DIRECTOR, CS BUSINESS SERIVICES)
(714) 509-7861
Entity
Organization

Contact information

Practice address
1201 W LA VETA AVE, ORANGE, CA 92868-4203
(888) 770-2462
Mailing address
1201 W LA VETA AVE, ORANGE, CA 92868-4203

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2080A0000X
Pediatric Adolescent Medicine Physician
2080B0002X
Pediatric Obesity Medicine Physician
363LP0200X
Pediatric Nurse Practitioner

Other

Enumeration date
09/27/2018
Last updated
10/26/2018
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