Provider Demographics
NPI:1669857637
Name:ORANGE COUNTY CRITICAL CARE & PULMONARY
Entity Type:Organization
Organization Name:ORANGE COUNTY CRITICAL CARE & PULMONARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLASABA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-432-1800
Mailing Address - Street 1:8201 NEWMAN AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-7043
Mailing Address - Country:US
Mailing Address - Phone:714-847-6900
Mailing Address - Fax:714-847-3900
Practice Address - Street 1:8201 NEWMAN AVE STE 101
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-7043
Practice Address - Country:US
Practice Address - Phone:714-847-6900
Practice Address - Fax:714-847-3900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102841261QM1300X, 332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACC648AMedicare PIN
CA1396958237Medicare UPIN