Organization Active NPI

Premium Health Oc Inc

  • General Practice Physician
  • Irvine, CA
National Provider Identifier
1831712496
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
PREMIUM HEALTH OC INC
Practice address
22 Odyssey Ste 240
Irvine, CA 92618-7700
Phone
(888) 700-0750
NPI assigned
May 18, 2020
Last updated
Sep 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Authorized official

Name
Alan Mohajer
Title
Director
Phone
(949) 408-1000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Occupational Medicine Physician 2083X0100X NU
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

22 Odyssey Ste 240
Irvine, CA 92618-7700

Mailing address

1800 E Garry Ave Ste 220
Santa Ana, CA 92705-5803
Phone (949) 408-1000

National Provider Directory

National Provider Directory

Locations

1800 E Garry Ave
Ste 220
Santa Ana, CA 92705

Practitioners & affiliated clinicians

Practitioners 1

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": "1589760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694736000000",
    "number": "1831712496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 E GARRY AVE STE 220",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927055803",
            "telephone_number": "949-408-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 ODYSSEY STE 240",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926187700",
            "telephone_number": "888-700-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM HEALTH OC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-18",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A",
        "authorized_official_last_name": "MOHAJER",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "949-408-1000"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.