NPIMap

Organization Active NPI

Mens Health and Wellness Center USA PC

  • Specialist
  • Costa Mesa, CA
National Provider Identifier
1578094496
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
C50947 Issued in CA
Legal business name
MENS HEALTH AND WELLNESS CENTER USA PC
Practice address
2755 Bristol St
280
Costa Mesa, CA 92626-5985
Phone
(714) 966-5362
Fax
(714) 966-5389
NPI assigned
Mar 22, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Authorized official

Name
Mrs. Joan Simpson
Title
Director of Compliance
Phone
(615) 562-4048

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X C50947 CA Primary

Addresses

Primary practice location

2755 Bristol St
280
Costa Mesa, CA 92626-5985

Mailing address

23275 S Pointe Dr
Suite 100
Laguna Hills, CA 92653-1474
Phone (714) 966-5352

National Provider Directory

National Provider Directory
Tax ID family
Men'S Health and Wellness Center USA PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2755 Bristol St
Ste 280
Costa Mesa, CA 92626
Phone (714) 966-5362

NPI Registry JSON

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490140800000",
    "number": "1578094496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23275 S POINTE DR",
            "address_2": "SUITE 100",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531474",
            "telephone_number": "714-966-5352",
            "fax_number": "714-966-5389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 BRISTOL ST",
            "address_2": "280",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265985",
            "telephone_number": "714-966-5362",
            "fax_number": "714-966-5389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENS HEALTH AND WELLNESS CENTER USA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-22",
        "last_updated": "2017-03-22",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "DIRECTOR OF COMPLIANCE",
        "authorized_official_telephone_number": "615-562-4048",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "C50947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; 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.