Provider Demographics
NPI:1720860059
Name:OSO PEDIATRICS, INC.
Entity Type:Organization
Organization Name:OSO PEDIATRICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNIQUE
Authorized Official - Middle Name:JUGANT
Authorized Official - Last Name:MCGREGOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-413-4719
Mailing Address - Street 1:24502 PACIFIC PARK DR STE 104
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-3033
Mailing Address - Country:US
Mailing Address - Phone:949-898-6220
Mailing Address - Fax:949-898-6221
Practice Address - Street 1:24502 PACIFIC PARK DR STE 104
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-3033
Practice Address - Country:US
Practice Address - Phone:949-898-6220
Practice Address - Fax:949-898-6221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty