Provider Demographics
NPI:1265709414
Name:ORANGE COUNTY HEALTHCARE INC
Entity type:Organization
Organization Name:ORANGE COUNTY HEALTHCARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUHEIR
Authorized Official - Middle Name:
Authorized Official - Last Name:KILANI
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:714-625-8320
Mailing Address - Street 1:9918 KATELLA AVE STE C
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-6466
Mailing Address - Country:US
Mailing Address - Phone:714-625-8320
Mailing Address - Fax:657-999-6396
Practice Address - Street 1:9918 KATELLA AVE
Practice Address - Street 2:STE C
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-6465
Practice Address - Country:US
Practice Address - Phone:714-625-8320
Practice Address - Fax:714-583-7660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-16
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGC642AMedicare Oscar/Certification
CAGC642AMedicare PIN