Organization Active NPI

Ronald Holness, M.D.,Inc

  • Specialist
  • Los Alamitos, CA
National Provider Identifier
1902931959
Registry record updated Nov 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G55605 Issued in CA
Legal business name
RONALD HOLNESS, M.D.,INC
Practice address
3801 Katella Ave
Ste. 420
Los Alamitos, CA 90720-3338
Phone
(562) 598-2439
Fax
(562) 598-0022
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2013

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

Authorized official

Name
Dr. Ronald C Holness, M.D.NPI 1114938867
Title
President
Phone
(562) 598-2439

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X G55605 CA Primary

Addresses

Primary practice location

3801 Katella Ave
Ste. 420
Los Alamitos, CA 90720-3338

Mailing address

3801 Katella Ave
Ste. 420
Los Alamitos, CA 90720-3338
Phone (562) 598-2439

Other identifiers 1

IdentifierTypeStateIssuer
00G556051MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315001165 CA Part B Supplier - Clinic/Group Practice 1951290998 Receives reassigned benefits from 1 practitioner
Practice locations: Los Alamitos, CA

National Provider Directory

National Provider Directory

Locations

3801 Katella Ave
Ste 42
Los Alamitos, CA 90720

3801 Katella Ave
Ste 420
Los Alamitos, CA 90720
Phone (562) 598-2439

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384300800000",
    "number": "1902931959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 KATELLA AVE",
            "address_2": "STE. 420",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203338",
            "telephone_number": "562-598-2439",
            "fax_number": "562-598-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 KATELLA AVE",
            "address_2": "STE. 420",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203338",
            "telephone_number": "562-598-2439",
            "fax_number": "562-598-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD HOLNESS, M.D.,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2013-11-13",
        "status": "A",
        "authorized_official_last_name": "HOLNESS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-598-2439",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G55605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G556051",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; 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.