Organization
CHILDREN'S HOSPITAL OF ORANGE COUNTY
Active
Parent organization
CHILDREN'S HOSPITAL OF ORANGE COUNTY
Other names
CS Developmental Behavioral
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) 509-7964
Entity
Organization
Contact information
Practice address
1201 W LA VETA AVE, ORANGE, CA 92868-4203
(714) 969-6118
(714) 969-9594
Mailing address
1201 W LA VETA AVE, ORANGE, CA 92868-4203
(714) 969-6118
(714) 969-9594
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
—
2085B0100X
Body Imaging Physician
—
—
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085P0229X
Pediatric Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Enumeration date
03/28/2013
Last updated
09/07/2017
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