NPIMap

Organization Active NPI

THC - Orange County, LLC

  • General Practice Physician
  • Brea, CA
National Provider Identifier
1902038169
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
THC - ORANGE COUNTY, LLC
Practice address
875 N Brea Blvd
Brea, CA 92821
Phone
(714) 529-6842
Fax
(714) 256-1041
NPI assigned
Aug 20, 2009
Last updated
Jul 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Authorized official

Name
Mr. Mostafa Adam Darvish
Title
Executive Director
Phone
(714) 893-4541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

875 N Brea Blvd
Brea, CA 92821

Mailing address

875 N Brea Blvd
Brea, CA 92821-2606
Phone (714) 529-6842

Other identifiers 1

IdentifierTypeStateIssuer
HSP30711FMedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
THC Orange County Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1902038169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 N BREA BLVD",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928212606",
            "telephone_number": "714-529-6842",
            "fax_number": "714-256-1041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 N BREA BLVD",
            "city": "BREA",
            "state": "CA",
            "postal_code": "92821",
            "telephone_number": "714-529-6842",
            "fax_number": "714-256-1041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THC - ORANGE COUNTY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-20",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "DARVISH",
        "authorized_official_first_name": "MOSTAFA",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "714-893-4541",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP30711F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.