Coordinated Health of Ca III, LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

COORDINATED HEALTH OF CA III, LLC

Practice address

2372C Morse Ave
Irvine, CA 92614-6234

Phone

(615) 386-0064

Fax

(615) 386-0067

NPI assigned

Jan 19, 2018

Organization subpart

No

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

Authorized official

Name

Edward Leland Hutton Eadie

Title

Director

Phone

(615) 733-2064

Specialties & licenses 2

Addresses

Other names 1

• Cardiac CIN of Orange County LLC Former legal business name

Locations

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

{
    "created_epoch": "1516320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579824000000",
    "number": "1578071924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 350",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372052216",
            "telephone_number": "615-386-0064",
            "fax_number": "615-386-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2372C MORSE AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926146234",
            "telephone_number": "615-386-0064",
            "fax_number": "615-386-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COORDINATED HEALTH OF CA III, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-19",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A",
        "authorized_official_last_name": "EADIE",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "LELAND HUTTON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-733-2064"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardiac CIN of Orange County LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Orthopaedic Surgery Physician in Irvine, CA
• Providers in Irvine, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; 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.