NPIMap

Organization Active NPI

Peter Anderson MD Medical Corporation

  • Emergency Medicine Physician
  • Fountain Valley, CA
National Provider Identifier
1659313880
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
PETER ANDERSON MD MEDICAL CORPORATION
Practice address
17100 Euclid St
Fountain Valley, CA 92708-4004
Phone
(714) 966-7200
NPI assigned
Jun 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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

Authorized official

Name
Peter G Anderson, MD
Title
President
Phone
(562) 809-3572

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

17100 Euclid St
Fountain Valley, CA 92708-4004

Mailing address

PO Box 51726
Los Angeles, CA 90051-6026
Phone (562) 809-3572

Other identifiers 1

IdentifierTypeStateIssuer
GR0046600MedicaidCA

Other names 1

  • Emergency Physicians Fountain Valley Medical Group Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422576000000",
    "number": "1659313880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51726",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900516026",
            "telephone_number": "562-809-3572"
        },
        {
            "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": "PETER ANDERSON MD MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2015-01-30",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-809-3572",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0046600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emergency Physicians Fountain Valley Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 30, 2015; 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.