NPIMap

Organization Active NPI

Physicians Network Services Medical Group

  • Optometrist
  • Placentia, CA
National Provider Identifier
1457445215
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PHYSICIANS NETWORK SERVICES MEDICAL GROUP
Practice address
377 E Chapman Ave
Ste 240
Placentia, CA 92870-5091
Phone
(714) 572-2039
NPI assigned
Oct 3, 2006
Last updated
May 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Authorized official

Name
William H Tabb, DPMNPI 1942307764
Title
Ceo
Phone
(714) 572-2039

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

377 E Chapman Ave
Ste 240
Placentia, CA 92870-5091

Mailing address

377 E Chapman Ave
Ste 240
Placentia, CA 92870-5091
Phone (714) 572-2039

Other identifiers 1

IdentifierTypeStateIssuer
GSD003040MedicaidCA

National Provider Directory

National Provider Directory

Locations

5250 Claremont Ave
Ste 225
Stockton, CA 95207
Phone (800) 869-9203

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1457445215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 E CHAPMAN AVE",
            "address_2": "STE 240",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928705091",
            "telephone_number": "714-572-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 E CHAPMAN AVE",
            "address_2": "STE 240",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928705091",
            "telephone_number": "714-572-2039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS NETWORK SERVICES MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "TABB",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-572-2039",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD003040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 May 12, 2008; 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.