NPIMap

Organization Active NPI

Secure Health Medical Group Inc

  • Non-Pharmacy Dispensing Site
  • Placentia, CA
National Provider Identifier
1376891580
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
A53433 Issued in CA
Legal business name
SECURE HEALTH MEDICAL GROUP INC
Practice address
1275 N Rose Dr
126
Placentia, CA 92870-3941
Phone
(714) 524-3880
NPI assigned
Aug 17, 2012
Organization subpart
Yes
Parent organization
MEDVANTX INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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

Authorized official

Name
Kenny Heine
Title
VP Ops
Phone
(858) 964-1506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X A53433 CA Primary

Addresses

Primary practice location

1275 N Rose Dr
126
Placentia, CA 92870-3941

Mailing address

5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705

Other names 1

  • SECURE HEALTH MEDICAL GROUP Doing business as

National Provider Directory

National Provider Directory
Part of
Tri - State Medical Group Inc

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1345161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351123200000",
    "number": "1376891580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 N ROSE DR",
            "address_2": "126",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928703941",
            "telephone_number": "714-524-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECURE HEALTH MEDICAL GROUP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX INC",
        "enumeration_date": "2012-08-17",
        "last_updated": "2012-10-25",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OPS",
        "authorized_official_telephone_number": "858-964-1506"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "A53433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SECURE HEALTH MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Placentia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.