Organization Active NPI

Corazon C Medina MD Inc

  • Internal Medicine Physician
  • Anaheim, CA
National Provider Identifier
1447309307
Registry record updated Mar 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CORAZON C MEDINA MD INC
Practice address
1751 W Romneya Dr
Ste H
Anaheim, CA 92801-1815
Phone
(714) 563-2114
NPI assigned
Jan 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2010

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

Authorized official

Name
Corazon C Medina, MDNPI 1083883904
Title
President
Phone
(714) 563-2114

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
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1751 W Romneya Dr
Ste H
Anaheim, CA 92801-1815

Mailing address

1751-H West Romneya Drive
Anaheim, CA 92801
Phone (714) 563-2114

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100520000912 CA Part B Supplier - Clinic/Group Practice 1951430438 Receives reassigned benefits from 1 practitioner
Practice locations: Anaheim, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0856340Corazon C Medina, MD Inc1751 W Romneya Dr, Ste H, Anaheim, CA 92801ComplianceOct 25, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268006400000",
    "number": "1447309307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751-H WEST ROMNEYA DRIVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "92801",
            "telephone_number": "714-563-2114",
            "fax_number": "714-563-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 W ROMNEYA DR",
            "address_2": "STE H",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011815",
            "telephone_number": "714-563-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAZON C MEDINA MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2010-03-08",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "CORAZON",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-563-2114",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.