Provider Demographics
NPI:1366941395
Name:ORANGE COUNTY HEART & VASCULAR INC
Entity type:Organization
Organization Name:ORANGE COUNTY HEART & VASCULAR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DINESH
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-246-5739
Mailing Address - Street 1:PO BOX 2111
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92814-0111
Mailing Address - Country:US
Mailing Address - Phone:714-617-5163
Mailing Address - Fax:
Practice Address - Street 1:1101 BRYAN AVE STE E
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-4401
Practice Address - Country:US
Practice Address - Phone:714-617-5163
Practice Address - Fax:714-617-5786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-05
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84090207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1942239306Medicaid