OrganizationOrange Park Medical Group, A Professional Corp.SpecialistOther Service ProvidersPractice Address2500 E Ball Rd Ste 200, Anaheim, CA 92806(714) 284-0111PECOS EnrollmentBased on the most recent information from CMS, provider Orange Park Medical Group, A Professional Corp. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 11:36 AM.Profile DetailsProvider ID1124369715Provider TypeOrganizationFull NameOrange Park Medical Group, A Professional Corp.SubpartNoEnumeration Date3/7/2013Last Updated3/12/2013Contact InformationPractice LocationPractice Address2500 E Ball Rd Ste 200, Anaheim, CA 92806Phone(714) 284-0111Fax(714) 284-0433Mailing LocationMailing Address2500 E Ball Rd Ste 200, Anaheim, CA 92806-5063Phone(714) 284-0111Fax(714) 284-0433Authorized OfficialNameAhmed, Ghazala (Secretary)Phone(714) 284-0111Provider TaxonomiesCodeDescriptionLicenseCode174400000XPrimaryDescriptionSpecialistOther Service ProvidersLicenseBUS2010-02745California