Individual provider Active NPI

Hashem M Fatemi

  • Cardiovascular Disease Physician
  • La Palma, CA
National Provider Identifier
1346262615
Registry record updated Mar 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A22624 Issued in CA
Practice address
5471 La Palma Ave
Suite 203
La Palma, CA 90623-1745
Phone
(714) 523-7122
Fax
(714) 523-9813
NPI assigned
Jul 24, 2006
Last updated
Mar 16, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A22624 CA Primary

Addresses

Primary practice location

5471 La Palma Ave
Suite 203
La Palma, CA 90623-1745

Mailing address

1811 Calavera PL
Fullerton, CA 92833-1823
Phone (714) 523-7122

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
I20090723000012 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 6305832932 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A22624CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intercommunity Cardiology a Medical Group Cardiovascular Disease CurrentSince Jan 30, 1988 Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients
Comprehensive Pain Care Medical Centers Inc. Past Accepting new patients

Locations

5471 La Palma Ave
Ste 103
La Palma, CA 90623
Phone (714) 523-7122

5471 La Palma Ave
Ste 203
La Palma, CA 90623
Phone (562) 424-2900

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.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237161600000",
    "number": "1346262615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 CALAVERA PL",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928331823",
            "telephone_number": "714-523-7122",
            "fax_number": "714-523-9813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5471 LA PALMA AVE",
            "address_2": "SUITE 203",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231745",
            "telephone_number": "714-523-7122",
            "fax_number": "714-523-9813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATEMI",
        "first_name": "HASHEM",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2009-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A22624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Palma, CA

Sources for this page

Verify at the official NPI Registry.