Basic Information
| Provider Information | |||||||||
| NPI: | 1851790331 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOAG OUTPATIENT THERAPIES LLC | ||||||||
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| OtherOrganizationName: | WOMANOLOGY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 SUPERIOR AVE | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | NEWPORT BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926633657 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9497644624 | ||||||||
| FaxNumber: | 9497645820 | ||||||||
| Practice Location | |||||||||
| Address1: | 18271 MCDURMOTT W STE J | ||||||||
| Address2: | |||||||||
| City: | IRVINE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926146754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9497522227 | ||||||||
| FaxNumber: | 9497522231 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2014 | ||||||||
| LastUpdateDate: | 12/17/2014 | ||||||||
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| AuthorizedOfficialLastName: | GUARNI | ||||||||
| AuthorizedOfficialFirstName: | ANDREW | ||||||||
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| AuthorizedOfficialTitleorPosition: | SENIOR VICE PRESIDENT FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 9497644624 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.