NPIMap

Organization Active NPI

Oso Specialty Infusion, Inc.

  • Infusion Therapy Clinic/Center
  • Irvine, CA
National Provider Identifier
1700305505
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X
Legal business name
OSO SPECIALTY INFUSION, INC.
Practice address
17175 Gillette Ave Ste B
Irvine, CA 92614-5602
Phone
(949) 735-6803
Fax
(949) 660-7139
NPI assigned
Sep 12, 2017
Last updated
Sep 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Randy Douglas Bohart, PHARMD
Title
Ceo
Phone
(949) 735-6803

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Clinic/Center 261QI0500X NU Primary

Addresses

Primary practice location

17175 Gillette Ave Ste B
Irvine, CA 92614-5602

Mailing address

17175 Gillette Ave Ste B
Irvine, CA 92614-5602
Phone (949) 735-6803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180227000349 CA Part B Supplier - Clinic/Group Practice 3274894720 Receives reassigned benefits from 19 practitioners
Practice locations: San Clemente, CA; Vista, CA; Redlands, CA; Northridge, CA; Mission Viejo, CA; Los Angeles, CA; Irvine, CA; Hemet, CA…

National Provider Directory

National Provider Directory

Locations

15785 Laguna Canyon Rd
Ste 100
Irvine, CA 92618
Phone (949) 364-2900

17175 Gillette Ave
Ste B
Irvine, CA 92614
Phone 94966071262100

76 Alabama St
Redlands, CA 92373

675 Camino de los Mares
Ste 403
San Clemente, CA 92673
Phone (949) 489-1960

2067 W Vista Way
Ste 140
Vista, CA 92083
Phone (760) 941-4444

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 31

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1700305505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17175 GILLETTE AVE STE B",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145602",
            "telephone_number": "949-735-6803",
            "fax_number": "949-660-7139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17175 GILLETTE AVE STE B",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145602",
            "telephone_number": "949-735-6803",
            "fax_number": "949-660-7139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSO SPECIALTY INFUSION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-12",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "BOHART",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-735-6803",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.