Provider Demographics
NPI:1033609375
Name:SOUTH ORANGE COUNTY HEMATOLOGY ONCOLOGY ASSOCIATES INC
Entity Type:Organization
Organization Name:SOUTH ORANGE COUNTY HEMATOLOGY ONCOLOGY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EMINA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-770-9454
Mailing Address - Street 1:24953 PASEO DE VALENCIA STE 25B
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-4341
Mailing Address - Country:US
Mailing Address - Phone:949-770-8168
Mailing Address - Fax:949-770-2991
Practice Address - Street 1:26691 PLAZA STE 200
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691
Practice Address - Country:US
Practice Address - Phone:949-347-0600
Practice Address - Fax:949-347-0746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-11
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Single Specialty