NPIMap

Organization Active NPI

Universal Care

  • Medical Specialty Clinic/Center
  • Garden Grove, CA
National Provider Identifier
1053400549
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
KNOX-KEENE 933-0209 Issued in CA
Legal business name
UNIVERSAL CARE
Practice address
12751 Harbor Boulevard
Garden Grove, CA 92840-5800
Phone
(714) 636-7852
Fax
(714) 636-0928
NPI assigned
Oct 12, 2006
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
John Donald Adams, DO
Title
Chief Medical Officer
Phone
(562) 981-4008

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X KNOX-KEENE 933-0209 CA Primary

Addresses

Primary practice location

12751 Harbor Boulevard
Garden Grove, CA 92840-5800

Mailing address

1600 E Hill Street
Signal Hill, CA 90755-3682
Phone (562) 424-6200

Other identifiers 1

IdentifierTypeStateIssuer
GR0019110MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Universal Care12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053400549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E HILL STREET",
            "city": "SIGNAL HILL",
            "state": "CA",
            "postal_code": "907553682",
            "telephone_number": "562-424-6200",
            "fax_number": "562-427-4634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12751 HARBOR BOULEVARD",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928405800",
            "telephone_number": "714-636-7852",
            "fax_number": "714-636-0928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DONALD",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "562-981-4008",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "KNOX-KEENE 933-0209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0019110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, 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.