ST JOSEPH HERITAGE HEALTHCARE (NPI# 1316243769) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316243769 |
| Entity Type | Organization |
| Organization Name | ST JOSEPH HERITAGE HEALTHCARE |
| Other Organization Name | ST JOSEPH HERITAGE HEALTHCARE |
| Practice Address |
2141 N Harbor Blvd Ste 35000 Fullerton CA 92835 |
| Mailing Address |
2141 N Harbor Blvd Ste 35000 Fullerton CA 92835-3831 |
| Practice Telephone | 7146268630 |
| Practice Fax Number | 7146268659 |
| Enumeration Date | 2011-02-02 |
| Last Update Date | 2018-12-05 |
| Authorized Official Name | RONALD MORELAND (SR. VICE PRESIDENT) |
| Authorized Official Telephone | 7149376200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | NSC | 6852510002 | 01 |
| Other Name | Type Code |
|---|---|
| ST JOSEPH HERITAGE HEALTHCARE | Doing Business As Name - Organization |
| St Jude Hospital Yorba Linda | Former Legal Business Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2141 N Harbor Blvd, Suite 35000, Fullerton, CA 928353827 | 7146268630 | 7146268659 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770068629 | St Joseph Heritage Healthcare | Family Medicine | 1 Edwards Way, Irvine, CA 92614-5688 | 2018-09-26 |
| 1609925957 | St Joseph Heritage Healthcare | Family Medicine | 500 S Main St Ste 1000, Orange, CA 92868-4533 | 2007-01-09 |
| 1639715709 | St Joseph Heritage Healthcare | Family Medicine | 200 W Center Street Promenade, Anaheim, CA 92805-3960 | 2019-11-22 |
| 1801443510 | St Joseph Heritage Healthcare | Internal Medicine | 1010 W La Veta Ave Ste 200, Orange, CA 92868-4301 | 2019-08-19 |
| 1427305960 | St Joseph Heritage Healthcare | Physical Medicine & Rehabilitation | 26522 La Alameda, Suite 120, Mission Viejo, CA 92691-6330 | 2012-08-14 |
| 1649551086 | St Joseph Heritage Healthcare | Anesthesiology | 2700 Dolbeer St, Eureka, CA 95501-4736 | 2011-08-30 |
| 1386937225 | St Joseph Heritage Healthcare | Durable Medical Equipment & Medical Supplies | 2826 Harris St, Eureka, CA 95503-4809 | 2011-05-25 |
| 1205131950 | St Joseph Heritage Healthcare | Durable Medical Equipment & Medical Supplies | 1100 Trancas St, Suite 209, Napa, CA 94558-2900 | 2011-01-11 |
| 1053616706 | St Joseph Heritage Healthcare | Durable Medical Equipment & Medical Supplies | 19333 Bear Valley Rd, Suite 106, Apple Valley, CA 92308-5148 | 2011-01-11 |
| 1740584473 | St Joseph Heritage Healthcare | Internal Medicine | 500 Doyle Park Dr, Suite 303, Santa Rosa, CA 95405-4558 | 2011-01-10 |
| Street Address |
2141 N HARBOR BLVD STE 35000 |
| City | FULLERTON |
| State | CA |
| Zip Code | 92835 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366442998 | Andrew Concoff | Internal Medicine | 2141 N Harbor Blvd Ste 35000, Fullerton, CA 92835-3831 | 2005-07-26 |
| 1013487883 | Austin James Perkins | Physician Assistant | 2141 N Harbor Blvd Ste 35000, Fullerton, CA 92835-3831 | 2018-12-04 |
| 1346716842 | Charles Alexandre Greener | Physician Assistant | 2141 N Harbor Blvd Ste 35000, Fullerton, CA 92835-3831 | 2018-10-23 |
| 1265946610 | Kate S. Boulder | Nurse Practitioner | 2141 N Harbor Blvd Ste 35000, Fullerton, CA 92835-3831 | 2017-11-21 |
| 1962787838 | Julie B Hastin | Physician Assistant | 2141 N Harbor Blvd Ste 35000, Fullerton, CA 92835-3831 | 2011-10-11 |
| 1588872089 | Carrie M Carrillo | Physician Assistant | 2141 N Harbor Blvd Ste 35000, Fullerton, CA 92835-3831 | 2007-05-18 |
| 1972726784 | Kyla Ama Davis | Physician Assistant | 2141 N Harbor Blvd Ste 35000, Fullerton, CA 92835-3831 | 2007-04-10 |
| 1760554232 | Kevin Kinzinger | Specialist | 2141 N Harbor Blvd Ste 35000, Fullerton, CA 92835-3831 | 2006-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538774302 | Natalie Baugh | Nutritionist | 333 W Bastanchury Rd 110, Fullerton, CA 92835 | 2020-09-09 |
| 1073127098 | Cecile Mae Sam | Physical Therapist | 2932 Clover Ct, Fullerton, CA 92835 | 2020-09-08 |
| 1861966087 | Kimson F Johnston | Marriage & Family Therapist | 1370 Brea Blvd Suite 210, Fullerton, CA 92835 | 2019-01-22 |
| 1134636327 | Michelle Harriman, Psychologist - A Professional Corporation | Psychologist | 1440 N Harbor Blvd Ste 808, Fullerton, CA 92835 | 2018-01-09 |
| 1659818631 | Jacqueline Rene Miller | Specialist/Technologist | 2610 Associated Rd, Apt A4, Fullerton, CA 92835 | 2017-01-27 |
| 1912361106 | John Nathaniel Alvarez | Psychiatry & Neurology | 401 E Imperial Highway, Fullerton, CA 92835 | 2016-04-13 |
| 1083075030 | Advance Recovery Solution, LLC | Substance Abuse Rehabilitation Facility | 3744 N Hermosa Pl, Fullerton, CA 92835 | 2016-03-17 |
| 1467817981 | Michele Ledesma | Physical Therapy Assistant | 2800 N. Harbor Blvd., Fullerton, CA 92835 | 2015-12-29 |
| 1467820571 | Jonghan Kang | Acupuncturist | 1321 N Harbor Blvd Ste 205, Fullerton, CA 92835 | 2015-09-04 |
| 1265840987 | Allison Leigh Kennedy | Physician Assistant | 100 Laguna Rd Ste 208, Fullerton, CA 92835 | 2014-07-25 |
| Find all providers in zip 92835 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821553967 | Assist Surgical | Orthopaedic Surgery | 301 W Bastanchury Rd Ste 125, Fullerton, CA 92835-3423 | 2019-02-03 |
| 1336418011 | Paul Henry Kirz | Orthopaedic Surgery | 1063 Carmel Cir, Fullerton, CA 92833-2076 | 2011-12-24 |
| 1619080587 | Joseph C Laughlin | Orthopaedic Surgery | 1345 Skyline Dr, Fullerton, CA 92831-1829 | 2006-08-16 |
| 1891795449 | Raed Ali | Orthopaedic Surgery | 100 E Valencia Mesa Dr, Suite 310, Fullerton, CA 92835-3813 | 2005-07-26 |
| 1548268287 | Shahram Solhpour | Orthopaedic Surgery | 2141 N Harbor Blvd, Suite 35000, Fullerton, CA 92835-3827 | 2005-07-07 |
| 1578715801 | Allen Y Tham | Orthopaedic Surgery | 2141 N Harbor Blvd, Suite 35000, Fullerton, CA 92835-3827 | 2008-10-17 |
| 1750452652 | Karen Elizabeth Evensen | Orthopaedic Surgery | 2141 N Harbor Blvd, Suite 35000, Fullerton, CA 92835-3827 | 2006-11-13 |
| 1265518443 | Kiarash Khajavi | Orthopaedic Surgery | 2141 N Harbor Blvd, Suite 35000, Fullerton, CA 92835-3827 | 2006-10-31 |
| 1023101375 | David Downs | Orthopaedic Surgery | 680 Langsdorf Dr, Suite 103, Fullerton, CA 92831-3702 | 2006-10-01 |
| 1275576795 | Mikel Whiting | Orthopaedic Surgery | 2141 N Harbor Blvd, Ste 35000, Fullerton, CA 92835 | 2006-06-13 |
| Find all providers in FULLERTON | ||||
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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.