OC TRAUMA INC (NPI# 1720516628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720516628 |
| Entity Type | Organization |
| Organization Name | OC TRAUMA INC |
| Practice Address |
26732 Crown Valley Pkwy Ste 351 Mission Viejo CA 92691-6374 |
| Practice Telephone | (949) 364-1007 |
| Practice Fax Number | 9495888719 |
| Mailing Telephone | 9493641007 |
| Mailing Fax Number | 9495888719 |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | DR. WILLIAM WALLACE (CEO) |
| Authorized Official Telephone | 9494577900 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTH ORANGE COUNTY SURGICAL MEDICAL GROUP, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0127X |
Surgery Specialization: Trauma Surgery |
Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 24411 Health Center Dr Ste 350, Laguna Hills, CA 926533687 | 9494577900 | 9495888719 |
| Street Address |
26732 CROWN VALLEY PKWY STE 351 |
| City | MISSION VIEJO |
| State | CA |
| Zip Code | 92691-6374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790946895 | Ahmad Abou Abbass | Transplant Surgery | 26732 Crown Valley Pkwy Ste 351, Mission Viejo, CA 92691 | 2008-06-20 |
| 1437702552 | Kathy Thanh Nguyen | Nurse Practitioner | 26732 Crown Valley Pkwy Ste 351, Mission Viejo, CA 92691-6374 | 2019-07-17 |
| 1649767476 | Katie Rose Rogers | Nurse Practitioner | 26732 Crown Valley Pkwy Ste 351, Mission Viejo, CA 92691-6374 | 2018-04-17 |
| 1477067882 | Oc General Surgery Inc | Surgery | 26732 Crown Valley Pkwy Ste 351, Mission Viejo, CA 92691-6374 | 2017-11-21 |
| 1548779168 | Jacob Chai | Nurse Practitioner | 26732 Crown Valley Pkwy Ste 351, Mission Viejo, CA 92691-6374 | 2017-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134748247 | Sonja Wood | Registered Nurse | 92691 Avenida Deseo, Mission Viejo, CA 92691 | 2020-04-09 |
| 1912488487 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 27551 Puerta Real, Mission Viejo, CA 92691 | 2018-08-23 |
| 1518457704 | Leon Baginski Md Inc | Obstetrics & Gynecology | 26800 Crown Valley Pkwy Ste 560, Mission Viejo, CA 92691 | 2018-05-14 |
| 1215426762 | Gail G Warner | Marriage & Family Therapist | 26050 Acero, Suite 301, Mission Viejo, CA 92691 | 2018-05-09 |
| 1508354176 | Tania Choudhary | Student in an Organized Health Care Education/Training Program | 23595 Rangoon St, Mission Viejo, CA 92691 | 2018-04-28 |
| 1710486519 | Aubriana Denise Gray | Counselor | 25802 Pacifica Ave, Mission Viejo, CA 92691 | 2018-02-07 |
| 1487162707 | Alberto Israel Galicia | Case Manager/Care Coordinator | 27261 Las Ramblas, Suite 220, Mission Viejo, CA 92691 | 2018-01-22 |
| 1629595244 | Elisabeth A Lischer | Counselor | 26137 La Paz Road, Suite 230, Mission Viejo, CA 92691 | 2017-08-24 |
| 1639694227 | Dr. Horiyat, A Dental Corporation | Dentist | 27652 Crown Valley Parkway, Mission Viejo, CA 92691 | 2017-08-04 |
| 1255851689 | Jackelin Liseth Martinez | Counselor | 25402 Pacifica Avenue, Mission Viejo, CA 92691 | 2017-06-27 |
| Find all providers in zip 92691 | ||||
| Taxonomy Code | 2086S0127X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Trauma Surgery |
| Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. |
| Notes: Source: American Board of Surgery, 2007 [1/1/2008: definition added, source added] Additional Resources: http://www.absurgery.org/. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952327348 | Mission Trauma Surgical Medical Grp | Surgery | 26732 Crown Valley Pkwy, Suite 351, Mission Viejo, CA 92691-6306 | 2006-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558809277 | Southern California Hepatobiliary Pancreatic and Robotic Surgery Ins | Surgery | 5805 Sepulveda Blvd Ste 690, Sherman Oaks, CA 91411 | 2017-02-01 |
| 1609212919 | Daniel Eldridge Smith | Surgery | 11175 Campus St # 21111, Loma Linda, CA 92350 | 2013-05-14 |
| 1841553187 | Ning Lu | Surgery | 9898 Genesee Ave Fl 1, La Jolla, CA 92037-1205 | 2012-06-21 |
| 1942588868 | Trauma & Critical Care Sfv Group Inc | Surgery | 11550 Indian Hills Road, Suite 310, Mission Hills, CA 91345 | 2011-07-26 |
| 1467652859 | Trauma Vascular Surgeons Inc | Surgery | 12400 Ventura Blvd # 374, Studio City, CA 91604-2406 | 2007-07-23 |
| 1194819532 | North County Trauma Services, Inc. | Surgery | 451 March Avenue, Suite B, Healdsburg, CA 95448-3387 | 2006-10-02 |
| 1598863193 | Lawrence Roberts | Surgery | 7930 Frost St Ste 204, San Diego, CA 92123-2739 | 2006-09-20 |
| 1467563791 | North County Trauma Associates, Inc. A Medical Group | Surgery | 215 South Hickory Avenue, Suite 112, Escondido, CA 92025-4360 | 2006-08-31 |
| 1922116987 | Dinh Nhatton Nguyen | Surgery | 1800 Harrison St Fl 7, Oakland, CA 94612-3466 | 2006-08-29 |
| 1477564474 | Todd A Kanen | Surgery | 5333 Hollister Ave Ste 210, Santa Barbara, CA 93111-3331 | 2006-08-11 |
| Find all providers with the same taxonomy | ||||
| City | MISSION VIEJO |
| Zip Code | 92691 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.