Provider Demographics
NPI:1992206940
Name:OC HEALTHY HEART LLC
Entity Type:Organization
Organization Name:OC HEALTHY HEART LLC
Other - Org Name:CARDIOVASCULAR WELLNESS INSTITUTE OF OC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:EUBANY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-312-5922
Mailing Address - Street 1:438 E KATELLA AVE SUITE B
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867
Mailing Address - Country:US
Mailing Address - Phone:714-744-5000
Mailing Address - Fax:714-744-5985
Practice Address - Street 1:438 E KATELLA AVE SUITE B
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867
Practice Address - Country:US
Practice Address - Phone:951-312-5922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-26
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA134183207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty