Organization Active NPI

Perinatal DX Medical GRP Or Orange County

  • Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
  • Fountain Valley, CA
National Provider Identifier
1003035882
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Obstetrics & Gynecology) PhysicianTaxonomy code 207VH0002X
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

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Obstetrics & Gynecology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
ZZZ95475ZOtherCABLUE SHIELD OF CA
GR0018070MedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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.

Verify at the official NPI Registry.