Organization Active NPI

Ascada Health PC

  • Family Medicine Physician
  • Fullerton, CA
National Provider Identifier
1811564479
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ASCADA HEALTH PC
Practice address
301 W Bastanchury Rd Ste 220
Fullerton, CA 92835-3424
Phone
(657) 230-7337
Fax
(657) 272-7720
NPI assigned
Jun 10, 2021
Last updated
Mar 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Authorized official

Name
Kevin OeiNPI 1063816809
Title
Owner
Phone
(657) 295-1333

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Primary Care Clinic/Center 261QP2300X NU
Urgent Care Clinic/Center 261QU0200X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

301 W Bastanchury Rd Ste 220
Fullerton, CA 92835-3424

Mailing address

301 W Bastanchury Rd Ste 220
Fullerton, CA 92835-3424
Phone (657) 230-7337

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210802000296 CA Part B Supplier - Mass Immunization (Roster Biller Only) 6406258037 Practice locations: Fullerton, CA; Huntington Beach, CA

National Provider Directory

National Provider Directory

Locations

1440 N Harbor Blvd
Ste 110
Fullerton, CA 92835
Phone (657) 212-3212

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1811564479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W BASTANCHURY RD STE 220",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353424",
            "telephone_number": "657-230-7337",
            "fax_number": "657-272-7720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W BASTANCHURY RD STE 220",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353424",
            "telephone_number": "657-230-7337",
            "fax_number": "657-272-7720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCADA HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-10",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "OEI",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "657-295-1333"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.