Provider Demographics
NPI:1710067673
Name:GASTROINTESTINAL HEALTHCARE OF ORANGE COUNTY, INC.
Entity Type:Organization
Organization Name:GASTROINTESTINAL HEALTHCARE OF ORANGE COUNTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:HABIB
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-276-2882
Mailing Address - Street 1:26691 PLAZA SUITE 150
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6329
Mailing Address - Country:US
Mailing Address - Phone:949-276-2882
Mailing Address - Fax:949-276-2885
Practice Address - Street 1:26691 PLAZA SUITE 150
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691
Practice Address - Country:US
Practice Address - Phone:949-276-2882
Practice Address - Fax:949-276-2885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2018-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA063719207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H31252Medicare UPIN
W20441Medicare PIN