Active NPI
J. Robert Egan, MD
- Gastroenterology Physician
- Anaheim, CA
National Provider Identifier
1114075082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- G5214
- Practice address
- 441 N Lakeview Ave
Anaheim, CA 92807-3028 - Phone
- (888) 988-2800
- NPI assigned
- Jan 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | G5214 | CA | Primary |
Addresses
Primary practice location
441 N Lakeview Ave
Anaheim, CA 92807-3028
Mailing address
441 N Lakeview Ave
Anaheim, CA 92807-3028
Phone (888) 988-2800
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: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5214 | CA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222128000000",
"number": "1114075082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "441 N LAKEVIEW AVE",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928073028",
"telephone_number": "888-988-2800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "441 N LAKEVIEW AVE",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928073028",
"telephone_number": "888-988-2800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EGAN",
"first_name": "J.",
"middle_name": "ROBERT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2008-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "CA",
"license": "G5214",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.