Organization Active NPI

Medical and Healing Arts, Inc

  • Community Health Clinic/Center
  • Fullerton, CA
National Provider Identifier
1225373590
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
G73630 Issued in CA
Legal business name
MEDICAL AND HEALING ARTS, INC
Practice address
515 E Commonwealth Ave
Fullerton, CA 92832-2020
Phone
(714) 871-7118
Fax
(714) 871-3372
NPI assigned
Nov 27, 2012
Last updated
Nov 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Authorized official

Name
Dr. Carl William Buckhorn, M.D.NPI 1649264847
Title
President
Phone
(714) 871-7118

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X G73630 CA Primary

Addresses

Primary practice location

515 E Commonwealth Ave
Fullerton, CA 92832-2020

Mailing address

515 E Commonwealth Ave
Fullerton, CA 92832-2020
Phone (714) 871-7118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130115000003 CA Part B Supplier - Clinic/Group Practice 9133372584 Receives reassigned benefits from 1 practitioner
Practice locations: Fullerton, CA

National Provider Directory

National Provider Directory

Locations

2282 N State College Blvd
#B
Fullerton, CA 92831
Phone (657) 378-9888

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1353974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353974400000",
    "number": "1225373590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 E COMMONWEALTH AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928322020",
            "telephone_number": "714-871-7118",
            "fax_number": "714-871-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 E COMMONWEALTH AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928322020",
            "telephone_number": "714-871-7118",
            "fax_number": "714-871-3372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL AND HEALING ARTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-27",
        "last_updated": "2012-11-27",
        "status": "A",
        "authorized_official_last_name": "BUCKHORN",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-871-7118",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": "G73630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 27, 2012; 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.