Southern California Electrophysiology Associates, Inc.

Primary specialty

Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X

License

A97240 Issued in CA

Legal business name

SOUTHERN CALIFORNIA ELECTROPHYSIOLOGY ASSOCIATES, INC.

Practice address

1211 W la Palma Ave Ste 408
Anaheim, CA 92801-2806

Phone

(714) 353-3250

Fax

(714) 386-5350

NPI assigned

Jun 22, 2010

Organization subpart

No

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

Authorized official

Name

Alicia Montanez, M.D.NPI 1326219783

Title

Medical Director

Phone

(714) 353-3250

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Southern Ca Electrophysiology2 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.

• Southern California Electrophysiology Associates

  • Non-Pharmacy Dispensing Site
  • Anaheim, CA
  • NPI 1184996423
  NPD tax ID

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alicia Montanez, MD

  • Clinical Cardiac Electrophysiology Physician
  • Anaheim, CA
  • NPI 1326219783

  CA, Clinical Cardiac Electrophysiology

  Medicare reassignment Care Compare group NPD Authorized official
• Ann Huynh Nguyen, NURSE PRACTITIONER

  • Acute Care Nurse Practitioner
  • Garden Grove, CA
  • NPI 1740060532

  CA

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282089600000",
    "number": "1114248382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4790 IRVINE BLVD",
            "address_2": "SUITE 105-177",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926201973",
            "telephone_number": "714-353-3250",
            "fax_number": "714-386-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W LA PALMA AVE STE 408",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012806",
            "telephone_number": "714-353-3250",
            "fax_number": "714-386-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA ELECTROPHYSIOLOGY ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-22",
        "last_updated": "2010-08-18",
        "status": "A",
        "authorized_official_last_name": "MONTANEZ",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "714-353-3250",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "CA",
            "license": "A97240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC. NUMBER",
            "identifier": "A97240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Anaheim, CA
• Clinical Cardiac Electrophysiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.