Anaheim Hills Medical Group, a Medical Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A7047 Issued in CA

Legal business name

ANAHEIM HILLS MEDICAL GROUP, A MEDICAL CORPORATION

Practice address

500 S Anaheim Hills Rd
Suite 242
Anaheim Hills, CA 92807-4780

Phone

(714) 974-0611

Fax

(714) 279-9183

NPI assigned

Dec 29, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Jason Christopher Berry, D.O.

Title

President

Phone

(714) 974-0611

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356328470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S ANAHEIM HILLS RD",
            "address_2": "SUITE 242",
            "city": "ANAHEIM HILLS",
            "state": "CA",
            "postal_code": "928074780",
            "telephone_number": "714-974-0611",
            "fax_number": "714-279-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S ANAHEIM HILLS RD",
            "address_2": "SUITE 242",
            "city": "ANAHEIM HILLS",
            "state": "CA",
            "postal_code": "928074780",
            "telephone_number": "714-974-0611",
            "fax_number": "714-279-9183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANAHEIM HILLS MEDICAL GROUP, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-974-0611",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A7047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Beavans Medical, Inc.
• Marc Becker, PH.D.

• Family Medicine Physician in Anaheim Hills, CA
• Providers in Anaheim Hills, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.