Provider Demographics
NPI:1912265257
Name:OC PEDIATRICS MEDICAL GROUP INC
Entity type:Organization
Organization Name:OC PEDIATRICS MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN-ELSAYED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-241-0117
Mailing Address - Street 1:26700 TOWNE CENTRE DR
Mailing Address - Street 2:STE 150
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-2844
Mailing Address - Country:US
Mailing Address - Phone:949-837-7337
Mailing Address - Fax:949-837-7347
Practice Address - Street 1:26700 TOWNE CENTRE DR
Practice Address - Street 2:STE 150
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-2844
Practice Address - Country:US
Practice Address - Phone:949-837-7337
Practice Address - Fax:949-837-7347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94330208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty