Provider Demographics
NPI:1427610138
Name:OC FAMILY & INDUSTRIAL PRACTICE
Entity type:Organization
Organization Name:OC FAMILY & INDUSTRIAL PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CALEB
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-362-8877
Mailing Address - Street 1:25431 CABOT RD STE 118
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-5527
Mailing Address - Country:US
Mailing Address - Phone:949-362-8877
Mailing Address - Fax:949-362-9230
Practice Address - Street 1:25431 CABOT RD STE 118
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-5527
Practice Address - Country:US
Practice Address - Phone:949-362-8877
Practice Address - Fax:949-362-9230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty