Provider Demographics
NPI:1043023658
Name:HOAG OUTPATIENT CENTERS, LLC
Entity type:Organization
Organization Name:HOAG OUTPATIENT CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-680-3443
Mailing Address - Street 1:500 SUPERIOR AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3659
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 SUPERIOR AVE STE 130
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3659
Practice Address - Country:US
Practice Address - Phone:949-520-7804
Practice Address - Fax:949-520-7805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical