Provider Demographics
NPI:1144416876
Name:ORANGE COUNTY CARE PROVIDERS,INC.
Entity Type:Organization
Organization Name:ORANGE COUNTY CARE PROVIDERS,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NASSRIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZAREI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-994-5210
Mailing Address - Street 1:20110 PIONEER BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-7402
Mailing Address - Country:US
Mailing Address - Phone:714-994-5210
Mailing Address - Fax:714-503-0735
Practice Address - Street 1:20110 PIONEER BLVD STE E
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-7402
Practice Address - Country:US
Practice Address - Phone:714-994-5210
Practice Address - Fax:714-503-0735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-17
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001625251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA058376Medicare Oscar/Certification