Alessa Medical Corporation

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A98851 Issued in CA

Legal business name

ALESSA MEDICAL CORPORATION

Practice address

6302 Princeville Cir
Huntington Beach, CA 92648-5524

Phone

(714) 514-8177

Fax

(714) 960-7655

NPI assigned

Mar 21, 2012

Last updated

Mar 21, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicole Wakim, MD

Title

Physician/Ceo

Phone

(714) 514-8177

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332288000000",
    "number": "1295000438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6302 PRINCEVILLE CIR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926485524",
            "telephone_number": "714-514-8177",
            "fax_number": "714-960-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6302 PRINCEVILLE CIR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926485524",
            "telephone_number": "714-514-8177",
            "fax_number": "714-960-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALESSA MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-21",
        "last_updated": "2012-03-21",
        "status": "A",
        "authorized_official_last_name": "WAKIM",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "PHYSICIAN/CEO",
        "authorized_official_telephone_number": "714-514-8177",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A98851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.