Organization Active NPI

Orange County First Medical Group a Professional Corporation

  • Internal Medicine Physician
  • Anaheim, CA
National Provider Identifier
1639264278
Registry record updated Mar 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ORANGE COUNTY FIRST MEDICAL GROUP A PROFESSIONAL CORPORATION
Practice address
1771 W. Romneya Dr.
Suite C
Anaheim, CA 92801-1817
Phone
(714) 520-3000
Fax
(714) 520-5742
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2014

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

Authorized official

Name
Dr. Syam Prasad Gaddam, M.D.NPI 1275510711
Title
Physician
Phone
(714) 636-9100

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1771 W. Romneya Dr.
Suite C
Anaheim, CA 92801-1817

Mailing address

1771 W. Romneya Dr.
Suite C
Anaheim, CA 92801-1817
Phone (714) 520-3000

Other identifiers 1

IdentifierTypeStateIssuer
GR0095540MedicaidCA

Other names 1

  • Anaheim Orange County First Medical Group Other name

National Provider Directory

National Provider Directory

Locations

1031 N Euclid St
Anaheim, CA 92801
Phone (714) 520-3000

1031 N Euclid St
Anaheim, CA 92801
Phone (714) 520-3000

24432 Muirlands Blvd
Ste 131
Lake Forest, CA 92630
Phone (714) 520-3000

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394582400000",
    "number": "1639264278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1771 W. ROMNEYA DR.",
            "address_2": "SUITE C",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011817",
            "telephone_number": "714-520-3000",
            "fax_number": "714-520-5742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 W. ROMNEYA DR.",
            "address_2": "SUITE C",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011817",
            "telephone_number": "714-520-3000",
            "fax_number": "714-520-5742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE COUNTY FIRST MEDICAL GROUP A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2014-03-12",
        "status": "A",
        "authorized_official_last_name": "GADDAM",
        "authorized_official_first_name": "SYAM",
        "authorized_official_middle_name": "PRASAD",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "714-636-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0095540",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anaheim Orange County First Medical Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; 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.