Provider Demographics
NPI:1750740080
Name:ORANGE COUNTY OROFACIAL PAIN ASSOCIATES INC
Entity type:Organization
Organization Name:ORANGE COUNTY OROFACIAL PAIN ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:CEBULA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-658-9004
Mailing Address - Street 1:301 S FAIR OAKS AVE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2561
Mailing Address - Country:US
Mailing Address - Phone:626-658-9004
Mailing Address - Fax:626-658-9034
Practice Address - Street 1:301 S FAIR OAKS AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2561
Practice Address - Country:US
Practice Address - Phone:626-658-9004
Practice Address - Fax:626-658-9034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-15
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1962464040OtherINDIVIDUAL NPI