Provider Demographics
NPI:1598829574
Name:ORANGE COAST ONCOLOGY HEMATOLOGY MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:ORANGE COAST ONCOLOGY HEMATOLOGY MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIASCIONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-474-5721
Mailing Address - Street 1:17500 RED HILL AVE
Mailing Address - Street 2:250
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-5645
Mailing Address - Country:US
Mailing Address - Phone:949-474-5720
Mailing Address - Fax:949-809-6497
Practice Address - Street 1:520 SUPERIOR AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3637
Practice Address - Country:US
Practice Address - Phone:949-646-6441
Practice Address - Fax:949-646-5719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW13856AMedicare PIN
CAW13856Medicare PIN