NPIMap

Organization Active NPI

Fountain Valley Regional Hospital and Medical Center

  • Pharmacotherapy Pharmacist
  • Fountain Valley, CA
National Provider Identifier
1083727960
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
44546 Issued in CA
Legal business name
FOUNTAIN VALLEY REGIONAL HOSPITAL AND MEDICAL CENTER
Practice address
11100 Warner Ave
Suite 318
Fountain Valley, CA 92708-7506
Phone
(714) 966-7217
Fax
(714) 966-3337
NPI assigned
Aug 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Authorized official

Name
Dr. Jennie Ung, PHARM. D
Title
Pharmacy Clinical Manager
Phone
(714) 966-7217

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 1835P1200X 44546 CA Primary

Addresses

Primary practice location

11100 Warner Ave
Suite 318
Fountain Valley, CA 92708-7506

Mailing address

17100 Euclid St
Fountain Valley, CA 92708-4004
Phone (714) 966-7217

National Provider Directory

National Provider Directory
Tax ID family
Fountain Valley Community2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

11100 Warner Ave
Ste 318
Fountain Vly, CA 92708
Phone (714) 966-7200

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543795200000",
    "number": "1083727960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17100 EUCLID ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084004",
            "telephone_number": "714-966-7217",
            "fax_number": "714-966-3337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "SUITE 318",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087506",
            "telephone_number": "714-966-7217",
            "fax_number": "714-966-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN VALLEY REGIONAL HOSPITAL AND MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2018-12-03",
        "status": "A",
        "authorized_official_last_name": "UNG",
        "authorized_official_first_name": "JENNIE",
        "authorized_official_title_or_position": "PHARMACY CLINICAL MANAGER",
        "authorized_official_telephone_number": "714-966-7217",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM. D"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "CA",
            "license": "44546",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 3, 2018; 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.