Provider Demographics
NPI:1356778245
Name:OC HEALTH AND PHYSICAL MEDICINE, INC.
Entity type:Organization
Organization Name:OC HEALTH AND PHYSICAL MEDICINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:CUBEIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-862-7499
Mailing Address - Street 1:18017 SKY PARK CIR STE F
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6579
Mailing Address - Country:US
Mailing Address - Phone:949-862-7499
Mailing Address - Fax:949-862-7496
Practice Address - Street 1:18017 SKY PARK CIR STE F
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6579
Practice Address - Country:US
Practice Address - Phone:949-862-7499
Practice Address - Fax:949-862-7496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-09
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG40805207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty