Provider Demographics
NPI:1922656156
Name:ORANGE COUNTY UROLOGY ASSOCIATES, INC. A MEDICAL GROUP
Entity Type:Organization
Organization Name:ORANGE COUNTY UROLOGY ASSOCIATES, INC. A MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-855-1101
Mailing Address - Street 1:16305 SAND CANYON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3783
Mailing Address - Country:US
Mailing Address - Phone:949-855-1101
Mailing Address - Fax:
Practice Address - Street 1:500 SUPERIOR AVE STE 305
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3660
Practice Address - Country:US
Practice Address - Phone:949-855-1011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORANGE COUNTY UROLOGY ASSOCIATES, INC. A MEDICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-30
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty