Provider Demographics
NPI:1003077330
Name:OCEAN MEDICAL INC
Entity Type:Organization
Organization Name:OCEAN MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-583-8780
Mailing Address - Street 1:999 N TUSTIN AVE
Mailing Address - Street 2:STE #16
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706
Mailing Address - Country:US
Mailing Address - Phone:866-583-8780
Mailing Address - Fax:866-583-8781
Practice Address - Street 1:999 N TUSTIN AVE
Practice Address - Street 2:STE 16
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-6504
Practice Address - Country:US
Practice Address - Phone:866-583-8780
Practice Address - Fax:866-583-8781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA011-01-5021174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty