Shunmugaraja Subbiah MD a Professional Medical Corporation

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

SHUNMUGARAJA SUBBIAH MD A PROFESSIONAL MEDICAL CORPORATION

Practice address

18111 Brookhurst St Ste 3200
Fountain Valley, CA 92708-6728

Phone

(714) 369-1100

Fax

(714) 464-4645

NPI assigned

Oct 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Shunmugaraja Subbiah, MDNPI 1184688715

Title

President

Phone

(714) 418-6522

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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

• Shunmugaraja Subbiah, M.D.

  • Anesthesiology Physician
  • Fountain Valley, CA
  • NPI 1184688715
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626825600000",
    "number": "1467549683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "714-347-1000",
            "fax_number": "714-647-1243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18111 BROOKHURST ST STE 3200",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086728",
            "telephone_number": "714-369-1100",
            "fax_number": "714-464-4645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHUNMUGARAJA SUBBIAH MD A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A",
        "authorized_official_last_name": "SUBBIAH",
        "authorized_official_first_name": "SHUNMUGARAJA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-418-6522",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A72997",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A729970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.