Provider Demographics
NPI:1225376809
Name:PLANNED PARENTHOOD/ORANGE AND SAN BERNARDINO COUNTIES, INC.
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD/ORANGE AND SAN BERNARDINO COUNTIES, INC.
Other - Org Name:MELODY HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHINEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-633-6373
Mailing Address - Street 1:801 E KATELLA AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-6614
Mailing Address - Country:US
Mailing Address - Phone:714-633-3736
Mailing Address - Fax:714-532-2929
Practice Address - Street 1:15403 PARK AVE E
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-2482
Practice Address - Country:US
Practice Address - Phone:909-890-5511
Practice Address - Fax:760-245-9008
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PLANNED PARENTHOOD/ORANGE AND SAN BERNARDINO COUNTIES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-01-16
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261Q00000X
CA261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05D1042218OtherCLIA WESTMINSTER LAB
CA05D0666696OtherCLIA ORANGE
CA550002375Medicaid