Provider Demographics
NPI:1922195296
Name:ORANGE COUNTY CARE PROVIDERS,INC.
Entity Type:Organization
Organization Name:ORANGE COUNTY CARE PROVIDERS,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NASSRIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:OMMI
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:714-994-5210
Mailing Address - Street 1:14700 E FIRESTONE BLVD STE 128
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638
Mailing Address - Country:US
Mailing Address - Phone:714-994-5210
Mailing Address - Fax:714-994-5213
Practice Address - Street 1:14700 E FIRESTONE BLVD STE 128
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638
Practice Address - Country:US
Practice Address - Phone:714-994-5210
Practice Address - Fax:714-994-5213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980001625251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA980001625OtherSTATE HOME HEALTH LICENSE