NPIMap

Organization Active NPI

Pacific Wavecrest Medical Corporation

  • Specialist
  • Anaheim, CA
National Provider Identifier
1871833715
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
43843 Issued in CA
Legal business name
PACIFIC WAVECREST MEDICAL CORPORATION
Practice address
2500 E Ball Rd
Ste 200
Anaheim, CA 92806-5054
Phone
(714) 284-0111
NPI assigned
Feb 28, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Authorized official

Name
Ms. Ghazala Ahmed
Title
Secretary
Phone
(714) 284-0111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 43843 CA Primary

Addresses

Primary practice location

2500 E Ball Rd
Ste 200
Anaheim, CA 92806-5054

Mailing address

2500 E Ball Rd
Ste 200
Anaheim, CA 92806-5054

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1362009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362009600000",
    "number": "1871833715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E BALL RD",
            "address_2": "STE 200",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928065054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E BALL RD",
            "address_2": "STE 200",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928065054",
            "telephone_number": "714-284-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC WAVECREST MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-28",
        "last_updated": "2013-02-28",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "GHAZALA",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "714-284-0111",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "43843",
            "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 Feb 28, 2013; 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.