Provider Demographics
NPI:1184979973
Name:OPTIMAL HEALTH MEDICAL OF ORANGE COUNTY
Entity type:Organization
Organization Name:OPTIMAL HEALTH MEDICAL OF ORANGE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHIL
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:949-297-3704
Mailing Address - Street 1:23101 LAKE CENTER DR STE 130
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-2874
Mailing Address - Country:US
Mailing Address - Phone:949-297-3704
Mailing Address - Fax:
Practice Address - Street 1:23101 LAKE CENTER DR STE 130
Practice Address - Street 2:SUITE 100
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-2874
Practice Address - Country:US
Practice Address - Phone:949-297-3704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86825207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty