NPIMap

Organization Active NPI

St Jude Hospital Yorba Linda

  • Family Medicine Physician
  • Fullerton, CA
National Provider Identifier
1023314044
Registry record updated Feb 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST JUDE HOSPITAL YORBA LINDA
Practice address
2720 N Harbor Blvd
Suite 130
Fullerton, CA 92835-2609
Phone
(714) 449-6230
NPI assigned
Feb 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2011

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

Authorized official

Name
John Bennett
Title
Chief Operating Officer
Phone
(714) 449-4800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

2720 N Harbor Blvd
Suite 130
Fullerton, CA 92835-2609

Mailing address

279 Imperial Hwy
Suite 730
Fullerton, CA 92835-1041
Phone (714) 449-4841

Other names 1

  • ST JOSEPH HERITAGE HEALTHCARE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Heritage HLTH FNDN44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1297209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297209600000",
    "number": "1023314044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 IMPERIAL HWY",
            "address_2": "SUITE 730",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928351041",
            "telephone_number": "714-449-4841",
            "fax_number": "714-449-4956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 N HARBOR BLVD",
            "address_2": "SUITE 130",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352609",
            "telephone_number": "714-449-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JUDE HOSPITAL YORBA LINDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-09",
        "last_updated": "2011-02-09",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "714-449-4800"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST JOSEPH HERITAGE HEALTHCARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2011; 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.