Individual provider Active NPI

Lian Bach, D.O.

  • Family Medicine Physician
  • Santa Ana, CA
National Provider Identifier
1144490962
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A10289 Issued in CA
Practice address
2212 E 4TH St
Santa Ana, CA 92705
Phone
(714) 288-3230
Fax
(714) 744-5294
NPI assigned
Mar 7, 2008
Last updated
Oct 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A10289 CA Primary

Addresses

Primary practice location

2212 E 4TH St
Santa Ana, CA 92705

Mailing address

2212 E 4TH St
Santa Ana, CA 92705-3870
Phone (714) 288-3230

Other practice location 1

3291 Loma Vista Rd
Ventura, CA 93003-3099
Phone (805) 652-6228

Other identifiers 1

IdentifierTypeStateIssuer
20A10289OtherCASTATE LIC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lbach1373712@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091110000705 CA Practitioner - Family Practice 3577601681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1095 Irvine Blvd
Tustin, CA 92780-3526
Phone (714) 505-7110

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

2212 E 4TH St
Santa Ana, CA 92705-3870
Phone (714) 633-1011

2501 E Chapman Ave
Orange, CA 92869-3204
Phone (714) 633-7175

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A10289CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation Family Medicine CurrentSince Oct 1, 2009 Accepting new patients
Providence Medical Foundation Family Medicine CurrentSince Oct 1, 2009 Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

2212 E 4th St
Santa Ana, CA 92705
Phone (714) 288-3230

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: lbach1373712@oc.providencedirect.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1144490962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2212 E 4TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053870",
            "telephone_number": "714-288-3230",
            "fax_number": "714-744-5294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 E 4TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92705",
            "telephone_number": "714-288-3230",
            "fax_number": "714-744-5294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3291 Loma Vista Rd",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930033099",
            "country_code": "US",
            "telephone_number": "805-652-6228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACH",
        "first_name": "LIAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-07",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A10289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC",
            "identifier": "20A10289",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lbach1373712@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2212 E 4th St",
            "city": "Santa Ana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "92705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.