Organization Active NPI

Clinica Buena Salud Inc

  • Family Medicine Physician
  • Santa Ana, CA
National Provider Identifier
1982779542
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CLINICA BUENA SALUD INC
Practice address
520 W 17TH St
1
Santa Ana, CA 92706-3614
Phone
(714) 972-2727
Fax
(714) 972-1193
NPI assigned
Nov 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Daniel Jimenez, M.D.NPI 1255466801
Title
Doctor
Phone
(714) 972-2727

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
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

520 W 17TH St
1
Santa Ana, CA 92706-3614

Mailing address

520 W 17TH St
1
Santa Ana, CA 92706-3614
Phone (714) 972-2727

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071106000469 CA Part B Supplier - Clinic/Group Practice 2466549514 Receives reassigned benefits from 4 practitioners
Practice locations: Santa Ana, CA

National Provider Directory

National Provider Directory

Locations

520 W 17th St
Ste 1
Santa Ana, CA 92706
Phone (714) 972-2727

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982779542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 W 17TH ST",
            "address_2": "1",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927063614",
            "telephone_number": "714-972-2727",
            "fax_number": "714-972-1193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 W 17TH ST",
            "address_2": "1",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927063614",
            "telephone_number": "714-972-2727",
            "fax_number": "714-972-1193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA BUENA SALUD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "714-972-2727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 22, 2020; 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.