Active NPI
Max Gouron, MD
- Specialist
- Santa Ana, CA
National Provider Identifier
1891789194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- A49690
- Practice address
- 1001 N Tustin Ave
Santa Ana, CA 92705-3502 - Phone
- (714) 953-3515
- NPI assigned
- Sep 1, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | A49690 | CA | Primary |
Addresses
Primary practice location
1001 N Tustin Ave
Santa Ana, CA 92705-3502
Mailing address
PO Box 4084
Tustin, CA 92781-4084
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A496900 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A49690 | CA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262908800000",
"number": "1891789194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4084",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927814084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 N TUSTIN AVE",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927053502",
"telephone_number": "714-953-3515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOURON",
"first_name": "MAX",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-01",
"last_updated": "2010-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "A49690",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A496900",
"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 Jan 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.