Active NPI
Telehealth Medical Group Inc
- Geriatric Medicine (Family Medicine) Physician
- Orange, CA
National Provider Identifier
1770864621
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Family Medicine) Physician
- License
- 20A4401
- Legal business name
- TELEHEALTH MEDICAL GROUP INC
- Practice address
- 615 E Chapman Ave
Orange, CA 92866-1643 - Phone
- (714) 639-4012
- Fax
- (714) 639-4018
- NPI assigned
- Sep 6, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Bryn Jarald Henderson, DO
- Title
- Partner
- Phone
- (714) 981-8058
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | 20A4401 | CA | Primary |
Addresses
Primary practice location
615 E Chapman Ave
Orange, CA 92866-1643
Mailing address
615 E Chapman Ave
Orange, CA 92866-1643
Phone (714) 639-4012
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryLocations
615 E Chapman Ave
Orange, CA 92866
Phone (714) 639-4012
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Orange, CA
- NPI 1447296694
-
- Internal Medicine Physician
- Inglewood, CA
- NPI 1104983873
-
- Family Medicine Physician
- Garden Grove, CA
- NPI 1467533356
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315267200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1543363200000",
"number": "1770864621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 E CHAPMAN AVE",
"city": "ORANGE",
"state": "CA",
"postal_code": "928661643",
"telephone_number": "714-639-4012",
"fax_number": "714-639-4018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 E CHAPMAN AVE",
"city": "ORANGE",
"state": "CA",
"postal_code": "928661643",
"telephone_number": "714-639-4012",
"fax_number": "714-639-4018"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TELEHEALTH MEDICAL GROUP INC",
"organizational_subpart": "NO",
"enumeration_date": "2011-09-06",
"last_updated": "2018-11-28",
"status": "A",
"authorized_official_last_name": "HENDERSON",
"authorized_official_first_name": "BRYN",
"authorized_official_middle_name": "JARALD",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "714-981-8058",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "207QG0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Geriatric Medicine",
"state": "CA",
"license": "20A4401",
"primary": true
}
],
"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 28, 2018; 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.