Provider Demographics
NPI:1073742185
Name:OC NEONATAL GROUP
Entity Type:Organization
Organization Name:OC NEONATAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:VEERAIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUNDU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-685-1130
Mailing Address - Street 1:151 S BELLEZA LN
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-3423
Mailing Address - Country:US
Mailing Address - Phone:714-685-1130
Mailing Address - Fax:714-685-1130
Practice Address - Street 1:151 S BELLEZA LN
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-3423
Practice Address - Country:US
Practice Address - Phone:714-685-1130
Practice Address - Fax:714-685-1130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA0461002080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty