NPIMap

Organization Active NPI

Bastanchury Heights Medical Group, Inc.

  • Obstetrics & Gynecology Physician
  • Fullerton, CA
National Provider Identifier
1972664258
Registry record updated Sep 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
BASTANCHURY HEIGHTS MEDICAL GROUP, INC.
Practice address
2264 N State College Blvd
Fullerton, CA 92831-1361
Phone
(714) 255-7045
Fax
(714) 256-4733
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2010

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

Authorized official

Name
Dr. Nicholas Thanos, M.D.NPI 1427088194
Title
President
Phone
(714) 990-2900

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
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X CA Primary

Addresses

Primary practice location

2264 N State College Blvd
Fullerton, CA 92831-1361

Mailing address

2264 N State College Blvd
Fullerton, CA 92831-1361
Phone (714) 255-7045

Other identifiers 1

IdentifierTypeStateIssuer
GR0050970MedicaidCA

Other names 1

  • Bastanchury Heights Medical Group, Center for Women's Health Care Doing business as

National Provider Directory

National Provider Directory

Locations

2264 N State College Blvd
Fullerton, CA 92831
Phone (714) 255-7045

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": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284940800000",
    "number": "1972664258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2264 N STATE COLLEGE BLVD",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928311361",
            "telephone_number": "714-255-7045",
            "fax_number": "714-256-4733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2264 N STATE COLLEGE BLVD",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928311361",
            "telephone_number": "714-255-7045",
            "fax_number": "714-256-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASTANCHURY HEIGHTS MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2010-09-20",
        "status": "A",
        "authorized_official_last_name": "THANOS",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-990-2900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0050970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bastanchury Heights Medical Group, Center for Women's Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.

Verify at the official NPI Registry.