Individual provider Active NPI

Paul Emile Wakim, D.O.

  • Orthopaedic Surgery Physician
  • Huntington Beach, CA
National Provider Identifier
1891857405
Registry record updated Oct 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
20A4964 Issued in CA
Practice address
18800 Delaware St Ste 1100
Huntington Beach, CA 92648-6021
Phone
(714) 841-5333
Fax
(714) 841-5303
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 20A4964 CA Primary

Addresses

Primary practice location

18800 Delaware St Ste 1100
Huntington Beach, CA 92648-6021

Mailing address

18800 Delaware St Suite 1100
Huntington Beach, CA 92648-5524
Phone (714) 841-5333

Other identifiers 1

IdentifierTypeStateIssuer
33-0978401OtherCATAX IDENTIFICATION NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050725000242 CA Practitioner - Orthopedic Surgery 6103853825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacifica Orthopedics Medical CorporationGroup PAC ID 0446208375, 4 clinicians

Practice addresses (Care Compare)

18800 Delaware St
Suite 1100
Huntington Beach, CA 92648-6021
Phone (714) 841-5333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4964CAMDSchool Counselor
20A4964CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacifica Orthopedics Medical Corporation Orthopaedic Surgery CurrentSince Aug 6, 2001 Accepting new patients
Pacifica Orthopedics Past Accepting new patients

Locations

18800 Delaware St
Ste 1100
Huntington Beach, CA 92648
Phone (714) 475-1100

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508803200000",
    "number": "1891857405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18800 DELAWARE ST SUITE 1100",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926485524",
            "telephone_number": "714-841-5333",
            "fax_number": "714-841-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18800 DELAWARE ST STE 1100",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926486021",
            "telephone_number": "714-841-5333",
            "fax_number": "714-841-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKIM",
        "first_name": "PAUL",
        "middle_name": "EMILE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2017-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "20A4964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "33-0978401",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.