Octiva Healthcare

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

OCTIVA HEALTHCARE

Practice address

12566 Valley View St
Garden Grove, CA 92846-4138

Phone

(704) 617-8535

NPI assigned

Jan 7, 2021

Organization subpart

No

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

Authorized official

Name

Cody Hall

Title

Ceo

Phone

(323) 590-9128

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646352000000",
    "number": "1447848270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2523 PLAMA VISTA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12566 VALLEY VIEW ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928464138",
            "telephone_number": "704-617-8535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCTIVA HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-07",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "CODY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-590-9128"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; 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.