Provider Demographics
NPI:1780053504
Name:OCHCA
Entity type:Organization
Organization Name:OCHCA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTER NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:BERNICE
Authorized Official - Middle Name:H
Authorized Official - Last Name:YOUNGS
Authorized Official - Suffix:
Authorized Official - Credentials:370327
Authorized Official - Phone:714-388-9278
Mailing Address - Street 1:8344 MULBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-3359
Mailing Address - Country:US
Mailing Address - Phone:714-388-9278
Mailing Address - Fax:714-834-7958
Practice Address - Street 1:1725 W 17TH ST RM 101-E
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-2316
Practice Address - Country:US
Practice Address - Phone:714-834-8752
Practice Address - Fax:714-834-7958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA370327261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center