| Thc - Orange County, Llc | |
|
875 N Brea Blvd Brea CA 92821 | |
| (714) 529-6842 | |
| (714) 256-1041 |
| Full Name | Thc - Orange County, Llc |
|---|---|
| Speciality | General Practice |
| Location | 875 N Brea Blvd, Brea, California |
| Authorized Official Name and Position | Mostafa Adam Darvish (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7148934541 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thc - Orange County, Llc 875 N Brea Blvd Brea CA 92821-2606 Ph: (714) 529-6842 | Thc - Orange County, Llc 875 N Brea Blvd Brea CA 92821 Ph: (714) 529-6842 |
| NPI Number | 1902038169 |
|---|---|
| Provider Enumeration Date | 08/20/2009 |
| Last Update Date | 07/19/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902038169 | NPI | - | NPPES |
| HSP30711F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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