St. Joseph - St. Theresa Medical, Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ST. JOSEPH - ST. THERESA MEDICAL, INC.

Doing business as

St. Joseph - St. Theresa Medical

Practice address

11180 Warner Ave
Fountain Valley, CA 92708-7501

Phone

(714) 760-4903

Fax

(714) 760-4349

NPI assigned

Apr 28, 2021

Organization subpart

No

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

Authorized official

Name

Lily H DO, DONPI 1841433653

Title

Owner / Medical Doctor

Phone

(714) 760-4903

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• St. Joseph - St. Theresa Medical Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lily Hoanglan DO, DO

  • Internal Medicine Physician
  • Bellflower, CA
  • NPI 1841433653
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619568000000",
    "number": "1790367779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087501",
            "telephone_number": "714-760-4903",
            "fax_number": "714-760-4349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087501",
            "telephone_number": "714-760-4903",
            "fax_number": "714-760-4349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH - ST. THERESA MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A",
        "authorized_official_last_name": "DO",
        "authorized_official_first_name": "LILY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER / MEDICAL DOCTOR",
        "authorized_official_telephone_number": "714-760-4903",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841433653",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "dr.hoanglan21@gmail.com",
            "affiliation": "N",
            "address_1": "11180 Warner Ave",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927087501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "St. Joseph - St. Theresa Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.