Individual provider Active NPI

Vivian DO

  • Physician Assistant
  • Orange, CA
National Provider Identifier
1033064373
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
68010 Issued in CA
Practice address
1140 W la Veta Ave Ste 640
Orange, CA 92868-4228
Phone
(714) 564-3300
NPI assigned
Mar 2, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 68010 CA Primary

Addresses

Primary practice location

1140 W la Veta Ave Ste 640
Orange, CA 92868-4228

Mailing address

1140 W la Veta Ave Ste 640
Orange, CA 92868-4228
Phone (714) 564-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1140 W la Veta Ave
Suite 640
Orange, CA 92868-4228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
68010CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tyson C. Cobb, M.D., Inc CurrentSince May 1, 2026 Accepting new patients
Orange County Heart Institute and Research Center a Medical Group CurrentSince May 1, 2026 Accepting new patients

Locations

1140 W La Veta Ave
Ste 640
Orange, CA 92868
Phone (714) 543-6054

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1772409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1033064373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 W LA VETA AVE STE 640",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684228",
            "telephone_number": "714-564-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 W LA VETA AVE STE 640",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684228",
            "telephone_number": "714-564-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "VIVIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-02",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "68010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.