Provider Demographics
NPI: | 1720538127 |
---|---|
Name: | OCEAN HEALTH GROUP LLC |
Entity type: | Organization |
Organization Name: | OCEAN HEALTH GROUP LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | HAROON |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CHAUDHRY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 323-417-0335 |
Mailing Address - Street 1: | 6464 W SUNSET BLVD |
Mailing Address - Street 2: | SUITE 790 |
Mailing Address - City: | HOLLYWOOD |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 90028-8001 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 323-417-0335 |
Mailing Address - Fax: | 646-304-1681 |
Practice Address - Street 1: | 1111 OCEAN AVE |
Practice Address - Street 2: | |
Practice Address - City: | BROOKLYN |
Practice Address - State: | NY |
Practice Address - Zip Code: | 11230-2039 |
Practice Address - Country: | US |
Practice Address - Phone: | 323-417-0335 |
Practice Address - Fax: | 646-304-1681 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-10-10 |
Last Update Date: | 2016-10-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | 211953 | 261QA1903X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QA1903X | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |