Provider Demographics
NPI:1790567444
Name:ORC CORP
Entity Type:Organization
Organization Name:ORC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:FERNANDO
Authorized Official - Last Name:PASTEN ROJO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-493-9457
Mailing Address - Street 1:1752 FERNWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-1563
Mailing Address - Country:US
Mailing Address - Phone:619-493-9457
Mailing Address - Fax:
Practice Address - Street 1:BOULEVARD DE LAS BELLAS ARTES 19315, NUEVA TIJUANA
Practice Address - Street 2:BOULEVAD DE LAS BELLAS ARTES 19315, NUEVA TIJUANA
Practice Address - City:TIJUANA
Practice Address - State:MEXICO
Practice Address - Zip Code:22435
Practice Address - Country:MX
Practice Address - Phone:664-873-2811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No333600000XSuppliersPharmacy
No341600000XTransportation ServicesAmbulance