Basic Information
| Provider Information | |||||||||
| NPI: | 1801834585 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FAMILY PRACTICE PHYSICIANS, A MEDICAL CORP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2540 N SANTIAGO BLVD | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928671862 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7149211030 | ||||||||
| FaxNumber: | 7149211032 | ||||||||
| Practice Location | |||||||||
| Address1: | 2540 N SANTIAGO BLVD | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928671862 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7149211030 | ||||||||
| FaxNumber: | 7149211032 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | CHOCEK | ||||||||
| AuthorizedOfficialFirstName: | SUSAN | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMININSTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 9513711222 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.