Active NPI
Perinatal DX Medical GRP Or Orange County
- Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
- Fountain Valley, CA
National Provider Identifier
1003035882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
- Legal business name
- PERINATAL DX MEDICAL GRP OR ORANGE COUNTY
- Practice address
- 11180 Warner Ave
#263
Fountain Valley, CA 92708-7501 - Phone
- (714) 241-9742
- Fax
- (714) 241-0136
- NPI assigned
- Apr 24, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Pam R Reed, RDMS
- Title
- Sonographer
- Phone
- (714) 241-9742
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician | 207VH0002X | Primary |
Addresses
Primary practice location
11180 Warner Ave
#263
Fountain Valley, CA 92708-7501
Mailing address
11180 Warner Ave
#263
Fountain Valley, CA 92708-7501
Phone (714) 241-9742
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ95475Z | Other | CA | BLUE SHIELD OF CA |
| GR0018070 | Medicaid | CA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Obstetrics & Gynecology Physician
- Irvine, CA
- NPI 1578520201
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1003035882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11180 WARNER AVE",
"address_2": "#263",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927087501",
"telephone_number": "714-241-9742",
"fax_number": "714-241-0136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11180 WARNER AVE",
"address_2": "#263",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927087501",
"telephone_number": "714-241-9742",
"fax_number": "714-241-0136"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PERINATAL DX MEDICAL GRP OR ORANGE COUNTY",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-24",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "REED",
"authorized_official_first_name": "PAM",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "SONOGRAPHER",
"authorized_official_telephone_number": "714-241-9742",
"authorized_official_credential": "RDMS"
},
"taxonomies": [
{
"code": "207VH0002X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology, Hospice and Palliative Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF CA",
"identifier": "ZZZ95475Z",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0018070",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fountain Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.