NPIMap

Organization Active NPI

Fountain Valley Emergency Physicians, P.C.

  • Emergency Medicine Physician
  • Fountain Valley, CA
National Provider Identifier
1639698475
Registry record updated Sep 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
FOUNTAIN VALLEY EMERGENCY PHYSICIANS, P.C.
Practice address
17100 Euclid St
Fountain Valley, CA 92708-4004
Phone
(714) 966-7200
NPI assigned
Sep 13, 2017
Last updated
Sep 13, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2017

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

Authorized official

Name
Timothy E. Korber, M.D.NPI 1104881481
Title
President
Phone
(949) 422-3812

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
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

17100 Euclid St
Fountain Valley, CA 92708-4004

Mailing address

825 Emerald Bay
Laguna Beach, CA 92651-1228
Phone (562) 468-0227

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171019000371 CA Part B Supplier - Clinic/Group Practice 5597031518 Receives reassigned benefits from 34 practitioners
Practice locations: Fountain Valley, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 34

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.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505260800000",
    "number": "1639698475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 EMERALD BAY",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926511228",
            "telephone_number": "562-468-0227",
            "fax_number": "562-924-5830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 EUCLID ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084004",
            "telephone_number": "714-966-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN VALLEY EMERGENCY PHYSICIANS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-13",
        "last_updated": "2017-09-13",
        "status": "A",
        "authorized_official_last_name": "KORBER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-422-3812",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2017; 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.