Provider Demographics
NPI:1942601844
Name:ORANGE COUNTY BARIATRIC SURGERY, INC.
Entity Type:Organization
Organization Name:ORANGE COUNTY BARIATRIC SURGERY, INC.
Other - Org Name:OC BARIATRIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-582-2530
Mailing Address - Street 1:255 W CENTRAL AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-3373
Mailing Address - Country:US
Mailing Address - Phone:714-582-2530
Mailing Address - Fax:
Practice Address - Street 1:255 W CENTRAL AVE STE 101
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-3373
Practice Address - Country:US
Practice Address - Phone:714-582-2530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62811208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty