PEDIATRIC SUBSPECIALTY FACULTY, INC. (NPI# 1144468620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144468620 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC SUBSPECIALTY FACULTY, INC. |
| Practice Address |
455 S Main St Psf Neonatology Orange CA 92868-3835 |
| Practice Telephone | 7145328620 |
| Practice Fax Number | 7142894072 |
| Mailing Telephone | 7145328620 |
| Mailing Fax Number | 7142894072 |
| Enumeration Date | 2009-01-22 |
| Last Update Date | 2009-01-22 |
| Authorized Official Name | HALE KUHLMAN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7142894511 |
| Is Organization Subpart | Y |
| Parent Organization Name | PEDIATRIC SUBSPECIALTY FACULTY, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1093905051 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417256918 | Pediatric Subspecialty Faculty, Inc. | Pediatrics | 455 S Main St, Orange, CA 92868-3835 | 2011-03-23 |
| 1639310113 | Pediatric Subspecialty Faculty, Inc. | Pediatrics | 455 S Main St, , Psf Developmental-behavioral Pediatrics, Orange, CA 92868-3835 | 2009-03-13 |
| 1265673743 | Pediatric Subspecialty Faculty, Inc. | Medical Genetics | 455 S Main St, Orange, CA 92868-3835 | 2009-03-13 |
| 1003054420 | Pediatric Subspecialty Faculty, Inc. | Surgery | 455 S Main St, General Surgery, Orange, CA 92868-3835 | 2009-01-22 |
| 1306098652 | Pediatric Subspecialty Faculty, Inc. | Otolaryngology | 455 S Main St, Orange, CA 92868-3835 | 2008-10-17 |
| 1790850279 | Pediatric Subspecialty Faculty, Inc. | Pediatrics | 1201 W La Veta Ave, Orange, CA 92868-4203 | 2006-11-21 |
| Street Address |
455 S MAIN ST PSF NEONATOLOGY |
| City | ORANGE |
| State | CA |
| Zip Code | 92868-3835 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033191473 | Nancy Ann Varni | Nurse Practitioner | 455 S Main St, Orange, CA 92868-3835 | 2005-11-18 |
| 1265776587 | Victor Wang | Pediatrics | 455 S Main St, Orange, CA 92868-3835 | 2012-11-27 |
| 1487906152 | Nancy Kuntz | Nurse Practitioner | 455 S Main St, Orange, CA 92868-3835 | 2012-10-05 |
| 1023360914 | Youngeun Park | Pediatrics | 455 S Main St, Orange, CA 92868-3835 | 2012-10-03 |
| 1295085918 | Stacey Jannette Bass | Nurse Practitioner | 455 S Main St, Orange, CA 92868-3835 | 2012-09-11 |
| 1003165267 | Jennifer Michelle Shively | Nurse Practitioner | 455 S Main St, Orange, CA 92868-3835 | 2012-09-04 |
| 1437406014 | Heidi Rens | Pharmacist | 455 S Main St, Orange, CA 92868-3835 | 2012-08-13 |
| 1992065361 | Jina Lim | Pediatrics | 455 S Main St, Orange, CA 92868-3835 | 2012-05-20 |
| 1386901700 | Elizabeth Marie Torok | Nurse Practitioner | 455 S Main St, Orange, CA 92868-3835 | 2012-04-23 |
| 1942578117 | Cassandra Lynn Stewart | Pediatrics | 455 S Main St, Orange, CA 92868-3835 | 2011-12-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346859386 | Sadaf Abrishami | Pharmacist | 101 The City Dr S., Orange, CA 92868 | 2020-07-27 |
| 1245869825 | Helena Yijia Hong | Student in an Organized Health Care Education/Training Program | Uci Medical Center, 101 The City Drive, Orange, CA 92868 | 2020-04-06 |
| 1932736527 | Joshua Kristopher Livingston | Student in an Organized Health Care Education/Training Program | 101 The City Dr S, Rte. 128-01, Orange, CA 92868 | 2020-03-24 |
| 1831725894 | Michelle Brown | Student in an Organized Health Care Education/Training Program | 101 The City Dr S. Rte 128-01, Orange, CA 92868 | 2020-03-20 |
| 1093363491 | Kristin Lee | Pharmacist | 132 S. Anita Dr., Orange, CA 92868 | 2019-08-28 |
| 1740834217 | Matthew Brian Mecheal | Dentist | 725 W. La Veta Suite 260, Orange, CA 92868 | 2019-08-01 |
| 1245897990 | Brent Tyler Louie | Student in an Organized Health Care Education/Training Program | 101 The City Drive South Building 3, Route 88, Neuropsychiatric Center Uc Irvine Medical Center, Orange, CA 92868 | 2019-05-28 |
| 1093277972 | Danielle Amato | Student in an Organized Health Care Education/Training Program | Uc Irvine Health 101 The City Drive, City Tower, Ste 40, Orange, CA 92868 | 2019-04-01 |
| 1851852206 | Julia Ting Bu | Student in an Organized Health Care Education/Training Program | Uc Irvine Health, 101 The City Drive, City Tower, Ste 400, Orange, CA 92868 | 2019-03-28 |
| 1326507344 | Harrison Beene Lowder | Student in an Organized Health Care Education/Training Program | 505 S. Main St, Suite 525, Orange, CA 92868 | 2019-03-19 |
| Find all providers in zip 92868 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295197325 | Bret Nolan | Pediatrics | 101 The City Dr S, Orange, CA 92868-3298 | 2016-03-28 |
| 1427493444 | Kristi Megan Kambestad | Pediatrics | 1201 W La Veta Ave, Orange, CA 92868-4203 | 2013-05-03 |
| 1023286101 | Rebecca Coleman | Pediatrics | 101 The City Dr S, Building 56, Suite 600, Orange, CA 92868-3201 | 2008-02-12 |
| 1265629612 | Michel Mikhael | Pediatrics | 455 S Main St, Orange, CA 92868-3835 | 2007-10-01 |
| 1396861951 | Carl Edwin Shangle | Pediatrics | 1201 W La Veta Ave, Choc Children's Specialists, Orange, CA 92868-4203 | 2007-03-22 |
| 1528114774 | Jack Howard Sills | Pediatrics | 101 The City Dr S, Orange, CA 92868-3201 | 2007-01-27 |
| 1235215484 | Carrie C Worcester | Pediatrics | 455 S Main St, Orange, CA 92868-3835 | 2006-10-31 |
| 1609951888 | Vijay Dhar | Pediatrics | 455 S Main St, Orange, CA 92868-3835 | 2006-10-26 |
| 1962582122 | Eugene L Mahmoud | Pediatrics | Uci Medical Center, 101 The City Drive South, Orange, CA 92868 | 2006-10-16 |
| 1841370004 | Houchang D Modanlou | Pediatrics | Uci Medical Center, 101 The City Drive South, Orange, CA 92868 | 2006-10-16 |
| Find all providers in ORANGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.