NPIMap

Individual provider Active NPI

Robert Tae Ha, MD

  • Internal Medicine Physician
  • Garden Grove, CA
National Provider Identifier
1750302188
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A055299 Issued in CA
Practice address
9896 Garden Grove Blvd
Garden Grove, CA 92844-1643
Phone
(714) 636-3032
Fax
(714) 636-3116
NPI assigned
Jul 21, 2006
Last updated
Dec 30, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A55299 CA
Internal Medicine Physician 207R00000X A055299 CA Primary

Addresses

Primary practice location

9896 Garden Grove Blvd
Garden Grove, CA 92844-1643

Mailing address

9896 Garden Grove Blvd
Garden Grove, CA 92844-1643
Phone (714) 636-3032

Other practice location 1

18111 Brookhurst St Ste 6300
Fountain Valley, CA 92708-6728
Phone (714) 847-6727

Other identifiers 1

IdentifierTypeStateIssuer
GA753AOtherCAMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100330001088 CA Practitioner - Internal Medicine 6406852904 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York Medical College, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

18111 Brookhurst St
Suite 6300
Fountain Valley, CA 92708-6728
Phone (714) 847-6727

9896 Garden Grove Blvd
Garden Grove, CA 92844-1643
Phone (714) 636-3032

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A55299CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohana Ipa Inc Current Accepting new patients
Center for Primary Care Medical Group Inc Internal Medicine CurrentSince Mar 1, 2010 Accepting new patients
Garden Grove Medical Group Inc CurrentSince Mar 1, 2012 Accepting new patients
Pasadena Hospital Association, LTD. Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients

Locations

18111 Brookhurst St
Ste 6300
Fountain Vly, CA 92708
Phone (714) 847-6727

8700 Warner Ave
Ste 140
Fountain Vly, CA 92708
Phone (714) 847-6727

12828 Harbor Blvd
Ste 320
Garden Grove, CA 92840
Phone (714) 636-0133

9896 Garden Grove Blvd
Garden Grove, CA 92844
Phone (714) 636-3032

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Starline Hospice, Inc.Los Angeles, CA, CCN 751685 Hospice Contracted Managing Employee May 21, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1750302188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9896 GARDEN GROVE BLVD",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441643",
            "telephone_number": "714-636-3032",
            "fax_number": "714-636-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9896 GARDEN GROVE BLVD",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441643",
            "telephone_number": "714-636-3032",
            "fax_number": "714-636-3116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18111 Brookhurst St Ste 6300",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927086728",
            "country_code": "US",
            "telephone_number": "714-847-6727",
            "fax_number": "714-847-6643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HA",
        "first_name": "ROBERT",
        "middle_name": "TAE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A55299",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A055299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "GA753A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.