Provider Demographics
NPI:1437695533
Name:OBRIA MEDICAL CLINIC
Entity Type:Organization
Organization Name:OBRIA MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VOLUNTEER R.N.
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:MARCHICA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:714-516-9045
Mailing Address - Street 1:1215 E CHAPMAN AVE STE 10
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-2237
Mailing Address - Country:US
Mailing Address - Phone:714-516-9045
Mailing Address - Fax:
Practice Address - Street 1:1215 E CHAPMAN AVE STE 10
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-2237
Practice Address - Country:US
Practice Address - Phone:714-516-9045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAZ234686261QF0050X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical