Organization Active NPI

Bedros H Kojian MD Inc

  • Clinic/Center
  • Orange, CA
National Provider Identifier
1487831665
Registry record updated Jan 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
A33708 Issued in CA
Legal business name
BEDROS H KOJIAN MD INC
Practice address
1310 W Stewart Dr Ste 308
Orange, CA 92868-3838
Phone
(714) 997-4110
Fax
(714) 997-4611
NPI assigned
Jan 30, 2008
Last updated
Jan 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2008

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

Authorized official

Name
Dr. Bedros H Kojian, M.D.NPI 1467498188
Title
President
Phone
(714) 997-4110

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
Clinic/Center 261Q00000X A33708 CA Primary

Addresses

Primary practice location

1310 W Stewart Dr Ste 308
Orange, CA 92868-3838

Mailing address

1310 W Stewart Dr Ste 308
Orange, CA 92868-3838
Phone (714) 997-4110

Other identifiers 1

IdentifierTypeStateIssuer
00A337080MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081016000082 CA Part B Supplier - Clinic/Group Practice 8022176205 Receives reassigned benefits from 1 practitioner
Practice locations: Orange, CA

National Provider Directory

National Provider Directory

Locations

1310 W Stewart Dr
Ste 308
Orange, CA 92868
Phone (714) 997-4110

Practitioners & affiliated clinicians

Practitioners 1

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": "1201651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201651200000",
    "number": "1487831665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 W STEWART DR STE 308",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683838",
            "telephone_number": "714-997-4110",
            "fax_number": "714-997-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 W STEWART DR STE 308",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683838",
            "telephone_number": "714-997-4110",
            "fax_number": "714-997-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEDROS H KOJIAN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-30",
        "last_updated": "2008-01-30",
        "status": "A",
        "authorized_official_last_name": "KOJIAN",
        "authorized_official_first_name": "BEDROS",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-997-4110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A33708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A337080",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; 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.