Basic Information
| Provider Information | |||||||||
| NPI: | 1043458771 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | UNITED CEREBRAL PALSY OF ORANGE COUNTY | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5809 | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928635809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9493336400 | ||||||||
| FaxNumber: | 9493336414 | ||||||||
| Practice Location | |||||||||
| Address1: | 1251 E DYER RD STE 150 | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927055662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9493336400 | ||||||||
| FaxNumber: | 9493336414 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2009 | ||||||||
| LastUpdateDate: | 02/09/2022 | ||||||||
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| AuthorizedOfficialLastName: | BASCHSHI | ||||||||
| AuthorizedOfficialFirstName: | RAMIN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9493336424 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| NPICertificationDate: | 02/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251P0200X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | 225XP0200X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | 235Z00000X | N | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 251S00000X | N | Agencies | Community/Behavioral Health | 251V00000X | Y | Agencies | Voluntary or Charitable |
No ID Information.