Organization Active NPI

Healthsource of Anaheim Inc

  • Chiropractor
  • Anaheim, CA
National Provider Identifier
1851440226
Registry record updated Mar 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
HEALTHSOURCE OF ANAHEIM INC
Practice address
716 S State College Blvd
Anaheim, CA 92806-4526
Phone
(714) 772-7100
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2009

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

Authorized official

Name
Amal F Cooper, D C
Title
President
Phone
(714) 772-7100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

716 S State College Blvd
Anaheim, CA 92806-4526

Mailing address

4760 Devonport Cir
Yorba Linda, CA 92887-2609
Phone (714) 772-7100

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ05681ZOtherCABLUE SHIELD GROUP ID

National Provider Directory

National Provider Directory

Locations

504 N State College Blvd
Anaheim, CA 92806
Phone (714) 772-7100

716 S State College Blvd
Anaheim, CA 92806
Phone (714) 772-7100

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": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237852800000",
    "number": "1851440226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 DEVONPORT CIR",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928872609",
            "telephone_number": "714-772-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 S STATE COLLEGE BLVD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928064526",
            "telephone_number": "714-772-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE OF ANAHEIM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2009-03-24",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "AMAL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-772-7100",
        "authorized_official_credential": "D C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP ID",
            "identifier": "ZZZ05681Z",
            "state": "CA"
        }
    ],
    "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 Mar 24, 2009; 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.