Provider Demographics
NPI:1457614950
Name:ORANGE COUNTY PHYSICAL MEDICINE GROUP, A PROFESSIONAL CORP.
Entity Type:Organization
Organization Name:ORANGE COUNTY PHYSICAL MEDICINE GROUP, A PROFESSIONAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:IRWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARLUK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-848-3603
Mailing Address - Street 1:8840 WARNER AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-3232
Mailing Address - Country:US
Mailing Address - Phone:714-848-3603
Mailing Address - Fax:714-848-3605
Practice Address - Street 1:8840 WARNER AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-3232
Practice Address - Country:US
Practice Address - Phone:714-848-3603
Practice Address - Fax:714-848-3605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC14902111NI0013X
CAG15995207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Multi-Specialty