NPIMap

Organization Active NPI

St Jude Hospital Yorba Linda

Doing business as St Joseph Heritage Healthcare

  • Family Medicine Physician
  • Fullerton, CA
National Provider Identifier
1124324579
Registry record updated Feb 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST JUDE HOSPITAL YORBA LINDA
Doing business as
St Joseph Heritage Healthcare
Practice address
2151 N Harbor Blvd
Suite 3200
Fullerton, CA 92835-3820
Phone
(714) 446-5101
NPI assigned
Feb 2, 2011
Last updated
Feb 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2011

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

Authorized official

Name
John Bennett
Title
Chief Operating Officer
Phone
(714) 449-4800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

2151 N Harbor Blvd
Suite 3200
Fullerton, CA 92835-3820

Mailing address

279 Imperial Hwy
Suite 730
Fullerton, CA 92835-1041
Phone (714) 449-4841

Other names 1

  • ST JOSEPH HERITAGE HEALTHCARE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Jude Hertiage Health44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

Locations

2151 N Harbor Blvd
Ste 3200
Fullerton, CA 92835
Phone (714) 446-5101

NPI Registry JSON

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

{
    "created_epoch": "1296604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296604800000",
    "number": "1124324579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 IMPERIAL HWY",
            "address_2": "SUITE 730",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928351041",
            "telephone_number": "714-449-4841",
            "fax_number": "714-449-4956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 N HARBOR BLVD",
            "address_2": "SUITE 3200",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353820",
            "telephone_number": "714-446-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JUDE HOSPITAL YORBA LINDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-02",
        "last_updated": "2011-02-02",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "714-449-4800"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST JOSEPH HERITAGE HEALTHCARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; 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.