Provider Demographics
NPI:1982783395
Name:OCMG, INC.
Entity Type:Organization
Organization Name:OCMG, INC.
Other - Org Name:ORANGE COUNTY MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:949-643-1132
Mailing Address - Street 1:26671 ALISO CREEK RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-4809
Mailing Address - Country:US
Mailing Address - Phone:949-643-1132
Mailing Address - Fax:949-425-1204
Practice Address - Street 1:26671 ALISO CREEK RD
Practice Address - Street 2:SUITE 205
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-4809
Practice Address - Country:US
Practice Address - Phone:949-643-1132
Practice Address - Fax:949-425-1204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-04
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6576261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service