Provider Demographics
NPI:1992880512
Name:THC - ORANGE COUNTY LLC
Entity type:Organization
Organization Name:THC - ORANGE COUNTY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT, CORPORATE SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:TEAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:629-253-5121
Mailing Address - Street 1:1940 EL CAJON BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-1005
Mailing Address - Country:US
Mailing Address - Phone:619-543-4500
Mailing Address - Fax:619-294-2979
Practice Address - Street 1:1940 EL CAJON BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104
Practice Address - Country:US
Practice Address - Phone:619-543-4500
Practice Address - Fax:619-294-2979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA090000059282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZT40220IOtherHEALTH NET
CAZZT30220IMedicaid
CA052035OtherBLUE CROSS
CA=========OtherKAISER PERMENENTE
CAZZT40220IOtherHEALTH NET
CA=========OtherUNITED HEALTHCARE
CA=========OtherHUMANA
CA=========OtherTRICARE/CHAMPUS
CAZZT30220IMedicaid
CA=========OtherCIGNA
CA=========OtherAETNA
CA=========OtherSECURE HORIZONS
05-2036Medicare Oscar/Certification