Fullerton Gardens, LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Legal business name

FULLERTON GARDENS, LLC

Practice address

1510 E Commonwealth Ave
Fullerton, CA 92831-4026

Phone

(714) 441-2636

Fax

(714) 441-0313

NPI assigned

Jun 19, 2007

Organization subpart

No

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

Authorized official

Name

Mr. John Holtz

Title

Controller

Phone

(541) 747-3373

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210636800000",
    "number": "1457556326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 CENTENNIAL LOOP",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974017900",
            "telephone_number": "541-747-3373",
            "fax_number": "541-747-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 E COMMONWEALTH AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928314026",
            "telephone_number": "714-441-2636",
            "fax_number": "714-441-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLERTON GARDENS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-19",
        "last_updated": "2008-05-13",
        "status": "A",
        "authorized_official_last_name": "HOLTZ",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "541-747-3373",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Point of Service in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Point of Service in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.