Active NPI
Consultants for Concept Development
Doing business as Anaheim Primary Care Medical Clinic
- Family Medicine Physician
- Anaheim, CA
National Provider Identifier
1982886230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- BUS007-02128
- Legal business name
- CONSULTANTS FOR CONCEPT DEVELOPMENT
- Doing business as
- Anaheim Primary Care Medical Clinic
- Practice address
- 1723 W Ball Rd
Anaheim, CA 92804-5502 - Phone
- (714) 635-0363
- Fax
- (714) 772-2994
- NPI assigned
- Nov 28, 2007
- Last updated
- Nov 28, 2007
- Organization subpart
- Yes
- Parent organization
- CONSULTANTS FOR CONCEPT DEVELOPMENT
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Candice Lee Junsay, PH.D
- Title
- Administrator
- Phone
- (714) 635-0363
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | BUS007-02128 | CA | Primary |
Addresses
Primary practice location
1723 W Ball Rd
Anaheim, CA 92804-5502
Mailing address
1723 W Ball Rd
Anaheim, CA 92804-5502
Phone (714) 635-0363
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A481003 | Medicaid | CA |
Other names 1
- ANAHEIM PRIMARY CARE MEDICAL CLINIC
National Provider Directory
National Provider Directory- Part of
- Consultants for Concept Development
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Medical Physician Assistant
- Anaheim, CA
- NPI 1215075841
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196208000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1196208000000",
"number": "1982886230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1723 W BALL RD",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928045502",
"telephone_number": "714-635-0363",
"fax_number": "714-772-2994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1723 W BALL RD",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928045502",
"telephone_number": "714-635-0363",
"fax_number": "714-772-2994"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CONSULTANTS FOR CONCEPT DEVELOPMENT",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CONSULTANTS FOR CONCEPT DEVELOPMENT",
"enumeration_date": "2007-11-28",
"last_updated": "2007-11-28",
"status": "A",
"authorized_official_last_name": "JUNSAY",
"authorized_official_first_name": "CANDICE",
"authorized_official_middle_name": "LEE",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "714-635-0363",
"authorized_official_credential": "PH.D"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "BUS007-02128",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A481003",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "ANAHEIM PRIMARY CARE MEDICAL CLINIC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.