| Full Name | |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 101 The City Dr S, Orange, California |
| Authorized Official Name and Position | Gina Churchill (REIMBURSEMENT DIRECTOR) |
| Authorized Official Contact | 9162403557 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1500 S Douglass Rd #200, Rt 183 Anaheim CA 92806 Ph: (916) 240-3557 | 101 The City Dr S Orange CA 92868 Ph: (714) 456-7295 |
| NPI Number | 1689608150 |
|---|---|
| Provider Enumeration Date | 07/10/2006 |
| Last Update Date | 10/16/2024 |
| Medicare PECOS PAC ID | 5395658181 |
|---|---|
| Medicare Enrollment ID | O20071207000726 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689608150 | NPI | - | NPPES |
| ZZT40348W | Medicaid | CA | |
| HSC30348W | Medicaid | CA | |
| ZZT30348G | Medicaid | CA | |
| ZZT40348G | Medicaid | CA | |
| HSC30348G | Medicaid | CA | |
| ZZT30348W | Medicaid | CA |
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