Provider Demographics
NPI:1750032082
Name:KEVIN OEI D.O. MEDICAL CORP
Entity Type:Organization
Organization Name:KEVIN OEI D.O. MEDICAL CORP
Other - Org Name:UPPER ECHELON MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OEI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:657-212-3212
Mailing Address - Street 1:1440 N HARBOR BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-4114
Mailing Address - Country:US
Mailing Address - Phone:657-212-3212
Mailing Address - Fax:657-212-3255
Practice Address - Street 1:1440 N HARBOR BLVD STE 110
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-4114
Practice Address - Country:US
Practice Address - Phone:657-212-3212
Practice Address - Fax:657-212-3255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-18
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty