Fullerton Pulmonary & Critical Care Inc

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

G84424 Issued in CA

Legal business name

FULLERTON PULMONARY & CRITICAL CARE INC

Practice address

1100 Alta Vista Dr
Fullerton, CA 92835-4027

Phone

(714) 871-1507

Fax

(949) 643-3560

NPI assigned

Oct 31, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Panagiotis Plato Bougas, M.D.

Title

President

Phone

(714) 871-1507

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1730368374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7630",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926077630",
            "telephone_number": "949-643-3345",
            "fax_number": "949-643-3560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 ALTA VISTA DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354027",
            "telephone_number": "714-871-1507",
            "fax_number": "949-643-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLERTON PULMONARY & CRITICAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "BOUGAS",
        "authorized_official_first_name": "PANAGIOTIS",
        "authorized_official_middle_name": "PLATO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-871-1507",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "G84424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "G84424",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G844240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pulmonary Disease Physician in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Pulmonary Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.