Premier Nephrology of Orange County Inc

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

PREMIER NEPHROLOGY OF ORANGE COUNTY INC

Practice address

11100 Warner Ave Ste 158
Fountain Valley, CA 92708-7510

Phone

(714) 486-2586

NPI assigned

Aug 21, 2019

Organization subpart

No

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

Authorized official

Name

Philip S. Yang, MDNPI 1821157553

Title

President

Phone

(714) 486-2586

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

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

• Philip Seungwoo Yang, MD

  • Nephrology Physician
  • Fountain Valley, CA
  • NPI 1821157553
  Medicare reassignment Care Compare group NPD Authorized official
• Son T. Dinh, M.D.

  • Nephrology Physician
  • Fountain Valley, CA
  • NPI 1174564256
  Medicare reassignment Care Compare group NPD
• Essam A Mostafa, M.D.

  • Nephrology Physician
  • Fountain Valley, CA
  • NPI 1316932270
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568592000000",
    "number": "1548817836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE STE 158",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087510",
            "telephone_number": "714-486-2586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE STE 158",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087510",
            "telephone_number": "714-486-2586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER NEPHROLOGY OF ORANGE COUNTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-21",
        "last_updated": "2019-09-16",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-486-2586",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Niewoehner Pommert
• Gina Posner, MD
• Pete Pow-Anpongkul
• Terry Ray Pracht, D.D.S.
• Benjamin David Preisendorf
• Premiercare Anesthesia Fountain Valley Inc
• Robereta Prepas, CNM
• Prestige Healthcare Services
• Prestige Medical Solutions
• Prevail Medical Equipment, Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.