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INTEGRATIVE MEDICAL CENTER NPI 1609017805


NPI Information

NPI: 1609017805
Provider Name: INTEGRATIVE MEDICAL CENTER
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 05D0581357

Address:
526 W 17TH ST
SANTA ANA, CA
ZIP 92706
Phone: (714) 558-9355
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INTEGRATIVE MEDICAL CENTER is a pediatrics in Santa Ana, CA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. INTEGRATIVE MEDICAL CENTER NPI is 1609017805. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

526 W 17TH ST
SANTA ANA, CA
ZIP 92706-619
Phone: (714) 558-9355
Fax: (714) 558-0870

The provider's authorized official is Patricia Hale .
The authorized official title is Administrator and has the following contact phone number (714) 558-9355.

The CLIA number assigned to this NPI record is 05D0581357 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/18/2009 and was last updated on 3/18/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsA53229CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11336275981MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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