NPIMap

Organization Active NPI

South Baylo University

  • Long Term Care Hospital
  • Anaheim, CA
National Provider Identifier
1659424760
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
License
AC4649 Issued in CA
Legal business name
SOUTH BAYLO UNIVERSITY
Practice address
1126 N Brookhurst St
3Rd Floor
Anaheim, CA 92801-1702
Phone
(714) 535-3886
Fax
(714) 535-3919
NPI assigned
Jan 19, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David Park
Title
President
Phone
(714) 533-1495

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X AC4649 CA Primary

Addresses

Primary practice location

1126 N Brookhurst St
3Rd Floor
Anaheim, CA 92801-1702

Mailing address

1126 N Brookhurst St
3Rd Floor
Anaheim, CA 92801-1702

National Provider Directory

National Provider Directory
Tax ID family
South Baylo University3 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

1126 N Brookhurst St
Fl 3
Anaheim, CA 92801
Phone (562) 866-5830

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659424760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 N BROOKHURST ST",
            "address_2": "3RD FLOOR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 N BROOKHURST ST",
            "address_2": "3RD FLOOR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011702",
            "telephone_number": "714-535-3886",
            "fax_number": "714-535-3919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAYLO UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-533-1495",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "CA",
            "license": "AC4649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 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.