NPIMap

Organization Active NPI

THC - Orange County, LLC

  • General Practice Physician
  • San Diego, CA
National Provider Identifier
1093947251
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
THC - ORANGE COUNTY, LLC
Practice address
1940 El Cajon Blvd
San Diego, CA 92104
Phone
(619) 543-4500
Fax
(619) 294-2979
NPI assigned
Aug 20, 2009
Last updated
Jul 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Authorized official

Name
Mr. Mostafa Adam Darvish
Title
Executive Director
Phone
(714) 893-4541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1940 El Cajon Blvd
San Diego, CA 92104

Mailing address

1940 El Cajon Blvd
San Diego, CA 92104-1005
Phone (619) 543-4500

Other identifiers 3

IdentifierTypeStateIssuer
ZZT30220IMedicaidCA
052035OtherCABLUE CROSS
ZZT40220IOtherCAHEALTH NET

National Provider Directory

National Provider Directory
Tax ID family
THC - Orange County LLC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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": "1250726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1093947251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 EL CAJON BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921041005",
            "telephone_number": "619-543-4500",
            "fax_number": "619-294-2979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 EL CAJON BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92104",
            "telephone_number": "619-543-4500",
            "fax_number": "619-294-2979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THC - ORANGE COUNTY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-20",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "DARVISH",
        "authorized_official_first_name": "MOSTAFA",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "714-893-4541",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT30220I",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "052035",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "ZZT40220I",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.