NPIMap

Organization Active NPI

Jack Lianjie Du, M.D., a Medical Corporation

  • Psychiatry Physician
  • Orange, CA
National Provider Identifier
1720080294
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
JACK LIANJIE DU, M.D., A MEDICAL CORPORATION
Practice address
1100 W Stewart Dr
Orange, CA 92868-3849
Phone
(714) 771-8134
Fax
(714) 744-8542
NPI assigned
Aug 12, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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

Authorized official

Name
Jack Lianjie Du, M.D.
Title
Owner
Phone
(714) 771-8134

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0800X Primary
Addiction Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0802X

Addresses

Primary practice location

1100 W Stewart Dr
Orange, CA 92868-3849

Mailing address

2913 El Camino Real
#603
Tustin, CA 92782-8909
Phone (714) 277-4200

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322524800000",
    "number": "1720080294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2913 EL CAMINO REAL",
            "address_2": "#603",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927828909",
            "telephone_number": "714-277-4200",
            "fax_number": "714-384-3889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W STEWART DR",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683849",
            "telephone_number": "714-771-8134",
            "fax_number": "714-744-8542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK LIANJIE DU, M.D., A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-12",
        "last_updated": "2011-11-29",
        "status": "A",
        "authorized_official_last_name": "DU",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "LIANJIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-771-8134",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; 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.