NPIMap

Organization Active NPI

Pes-Ebs.Inc.

  • Community/Behavioral Health Agency
  • Santa Ana, CA
National Provider Identifier
1851763882
Registry record updated Sep 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
608733 Issued in CA
Legal business name
PES-EBS.INC.
Practice address
600 W Santa Ana Blvd
Suites 107, 108, 109, & 110
Santa Ana, CA 92701-5458
Phone
(714) 667-7926
Fax
(530) 888-9065
NPI assigned
Oct 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2016

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

Authorized official

Name
Mr. Walter Stockman
Title
President
Phone
(530) 888-1010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 608733 CA Primary

Addresses

Primary practice location

600 W Santa Ana Blvd
Suites 107, 108, 109, & 110
Santa Ana, CA 92701-5458

Mailing address

600 W Santa Ana Blvd
Suites 107, 108, 109, & 110
Santa Ana, CA 92701-5458
Phone (714) 667-7926

Other identifiers 1

IdentifierTypeStateIssuer
8048OtherCADRUG MEDI-CAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251008004634 CA Part B Supplier - Clinic/Group Practice 7113424755 Receives reassigned benefits from 1 practitioner
Practice locations: Santa Ana, CA

National Provider Directory

National Provider Directory
Tax ID family
Pes-Ebsinc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

600 W Santa Ana Blvd
Ste 109
Santa Ana, CA 92701
Phone (714) 667-7926

600 W Santa Ana Blvd
Ste 107
Santa Ana, CA 92701
Phone (714) 667-7926

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473984000000",
    "number": "1851763882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W SANTA ANA BLVD",
            "address_2": "SUITES 107, 108, 109, & 110",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927015458",
            "telephone_number": "714-667-7926",
            "fax_number": "530-888-9065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W SANTA ANA BLVD",
            "address_2": "SUITES 107, 108, 109, & 110",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927015458",
            "telephone_number": "714-667-7926",
            "fax_number": "530-888-9065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PES-EBS.INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-29",
        "last_updated": "2016-09-16",
        "status": "A",
        "authorized_official_last_name": "STOCKMAN",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-888-1010",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "608733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRUG MEDI-CAL",
            "identifier": "8048",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; 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.