Organization Active NPI

Katella Medical Group Inc

  • Internal Medicine Physician
  • Anaheim, CA
National Provider Identifier
1831251495
Registry record updated Jan 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A79531 Issued in CA
Legal business name
KATELLA MEDICAL GROUP INC
Practice address
9876 Katella Ave.
Anaheim, CA 92804
Phone
(714) 534-4001
Fax
(714) 534-4122
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2018

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

Authorized official

Name
Dr. Scott Hoan Tran, M.D.NPI 1922183342
Title
President
Phone
(714) 534-4001

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)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A79531 CA Primary

Addresses

Primary practice location

9876 Katella Ave.
Anaheim, CA 92804

Mailing address

9876 Katella Ave.
Anaheim, CA 92804
Phone (714) 534-4001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050622000766 CA Part B Supplier - Clinic/Group Practice 5092750885 Receives reassigned benefits from 1 practitioner
Practice locations: Anaheim, CA

National Provider Directory

National Provider Directory

Locations

9876 Katella Ave
Anaheim, CA 92804
Phone (714) 534-4001

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516665600000",
    "number": "1831251495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9876 KATELLA AVE.",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "92804",
            "telephone_number": "714-534-4001",
            "fax_number": "714-534-4122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9876 KATELLA AVE.",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "92804",
            "telephone_number": "714-534-4001",
            "fax_number": "714-534-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATELLA MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2018-01-23",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "HOAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-534-4001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A79531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.

Verify at the official NPI Registry.