Organization Active NPI

Advanced Family Medical Group, Inc

  • Family Medicine Physician
  • Anaheim, CA
National Provider Identifier
1710091103
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ADVANCED FAMILY MEDICAL GROUP, INC
Practice address
1771-B W. Romneya Drive
Anaheim, CA 92801-1816
Phone
(714) 490-1200
Fax
(562) 531-3596
NPI assigned
Aug 19, 2006
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
Chander SharmaNPI 1588778930
Title
MD
Phone
(714) 490-1200

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
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1771-B W. Romneya Drive
Anaheim, CA 92801-1816

Mailing address

1771-B W. Romneya Drive
Anaheim, CA 92801-1816
Phone (714) 490-1200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130306000178 CA Part B Supplier - Clinic/Group Practice 1658526272 Receives reassigned benefits from 1 practitioner
Practice locations: Anaheim, CA

National Provider Directory

National Provider Directory

Locations

1771 W Romneya Dr
Ste B
Anaheim, CA 92801
Phone (714) 490-1200

16415 Colorado Ave
Ste 304
Paramount, CA 90723
Phone (562) 531-4171

Practitioners & affiliated clinicians

Practitioners 1

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": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710091103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1771-B W. ROMNEYA DRIVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011816",
            "telephone_number": "714-490-1200",
            "fax_number": "562-531-3596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771-B W. ROMNEYA DRIVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011816",
            "telephone_number": "714-490-1200",
            "fax_number": "562-531-3596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FAMILY MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "CHANDER",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "714-490-1200"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "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.
  • 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.