Organization Active NPI

Allied Anesthesia Medical Group Inc

  • Anesthesiology Physician
  • Orange, CA
National Provider Identifier
1346267267
Registry record updated Feb 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ALLIED ANESTHESIA MEDICAL GROUP INC
Practice address
1100 W Stewart Dr
Orange, CA 92868-3849
Phone
(714) 633-9111
Fax
(714) 744-8695
NPI assigned
Jul 16, 2006
Last updated
Feb 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2015

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

Authorized official

Name
Kaveh Matin, M.D.NPI 1457371346
Title
President / Authorized Official
Phone
(714) 619-4730

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
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

1100 W Stewart Dr
Orange, CA 92868-3849

Mailing address

PO Box 1628
Orange, CA 92856-0628
Phone (714) 560-1580

Other identifiers 2

IdentifierTypeStateIssuer
GR0059140MedicaidCA
ZZZ40419ZOtherCABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040126001001 CA Part B Supplier - Clinic/Group Practice 6103728407 Receives reassigned benefits from 411 practitioners

National Provider Directory

National Provider Directory

Locations

15825 Laguna Canyon Rd
Irvine, CA 92618
Phone (949) 341-3499

1310 W Stewart Dr
Ste 303
Orange, CA 92868
Phone (714) 738-4621

681 S Parker St
Orange, CA 92868
Phone (714) 744-0439

901 San Bernardino Rd
#200
Upland, CA 91786
Phone (909) 579-1500

901 San Bernardino Rd
Ste 200
Upland, CA 91786
Phone (909) 579-1500

Practitioners & affiliated clinicians

Practitioners 430

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.

View all 430

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424304000000",
    "number": "1346267267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1628",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928560628",
            "telephone_number": "714-560-1580",
            "fax_number": "714-560-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W STEWART DR",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683849",
            "telephone_number": "714-633-9111",
            "fax_number": "714-744-8695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIED ANESTHESIA MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2015-02-19",
        "status": "A",
        "authorized_official_last_name": "MATIN",
        "authorized_official_first_name": "KAVEH",
        "authorized_official_title_or_position": "PRESIDENT / AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "714-619-4730",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0059140",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ40419Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; 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.