Organization Active NPI

Southern California Hospitalist Network Medical Group Inc

  • Internal Medicine Physician
  • Orange, CA
National Provider Identifier
1790880458
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SOUTHERN CALIFORNIA HOSPITALIST NETWORK MEDICAL GROUP INC
Practice address
625 The City Dr S Ste 320
Orange, CA 92868-4978
Phone
(714) 202-2330
Fax
(714) 333-4130
NPI assigned
Sep 14, 2006
Last updated
Dec 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Authorized official

Name
Kristin Hasty
Title
Delegated Official
Phone
(714) 202-2330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

625 The City Dr S Ste 320
Orange, CA 92868-4978

Mailing address

PO Box 8206
Anaheim, CA 92812-0206
Phone (714) 780-5695

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040324001749 CA Part B Supplier - Clinic/Group Practice 8921990110 Receives reassigned benefits from 186 practitioners
Practice locations: Hemet, CA; Orange, CA; Sun City, CA

National Provider Directory

National Provider Directory

Locations

2040 S Santa Cruz St
Ste 240
Anaheim, CA 92805
Phone (714) 202-2330

625 The City Dr S
Orange, CA 92868
Phone (714) 202-2330

625 The City Dr S
Ste 320
Orange, CA 92868
Phone (714) 202-2330

28400 McCall Blvd
Sun City, CA 92585
Phone (909) 679-8888

Practitioners & affiliated clinicians

Practitioners 236

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 236

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1790880458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8206",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928120206",
            "telephone_number": "714-780-5695",
            "fax_number": "714-780-5694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 THE CITY DR S STE 320",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684978",
            "telephone_number": "714-202-2330",
            "fax_number": "714-333-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA HOSPITALIST NETWORK MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A",
        "authorized_official_last_name": "HASTY",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "714-202-2330"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "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 Dec 11, 2024; 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.