Provider Demographics
NPI:1730416298
Name:ORANGE COUNTY HEMATOLOGY-ONCOLOGY MEDICAL GROUP PC
Entity type:Organization
Organization Name:ORANGE COUNTY HEMATOLOGY-ONCOLOGY MEDICAL GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DUVIVIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-953-6246
Mailing Address - Street 1:1401 N TUSTIN AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-8644
Mailing Address - Country:US
Mailing Address - Phone:714-953-6246
Mailing Address - Fax:
Practice Address - Street 1:1401 N TUSTIN AVE
Practice Address - Street 2:220
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-8644
Practice Address - Country:US
Practice Address - Phone:714-953-6246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG67229207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty