Provider Demographics
NPI:1225419302
Name:CHILDREN'S HOSPITAL OF ORANGE COUNTY
Entity Type:Organization
Organization Name:CHILDREN'S HOSPITAL OF ORANGE COUNTY
Other - Org Name:CYS CHOC CO-OCCURRING CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER AND VICE PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MINON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-509-8413
Mailing Address - Street 1:1120 W LA VETA AVE STE 470
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4233
Mailing Address - Country:US
Mailing Address - Phone:714-509-8481
Mailing Address - Fax:714-509-4374
Practice Address - Street 1:1120 W LA VETA AVE STE 470
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4233
Practice Address - Country:US
Practice Address - Phone:714-509-8481
Practice Address - Fax:714-509-4374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-15
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren