ANZA COMMUNITY MEDICAL CENTER (NPI# 1619000775) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619000775 |
| Entity Type | Organization |
| Organization Name | ANZA COMMUNITY MEDICAL CENTER |
| Practice Address |
56480 Highway 371 Anza CA 92539 |
| Mailing Address |
Po Box 391487 Anza CA 92539-1487 |
| Practice Telephone | 9516948549 |
| Practice Fax Number | 9516940249 |
| Mailing Telephone | 9516948549 |
| Mailing Fax Number | 9516940249 |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2008-07-08 |
| Authorized Official Name | DR. JONATHAN YUJUNG YUN (PRESIDENT) |
| Authorized Official Telephone | 9515666778 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
20A8759 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00AX87590 | 05 |
| Street Address |
56480 HIGHWAY 371 |
| City | ANZA |
| State | CA |
| Zip Code | 92539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942485610 | Anza Community Medical Center Corp | Clinic/Center | 56480 Highway 371, Anza, CA 92539 | 2007-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730656349 | Olusoji Akanwo | Pharmacist | 56555 Hwy 371, Anza, CA 92539 | 2018-11-01 |
| 1942623657 | Borrego Community Health Foundation | Clinic/Center | 58581 Us Highway 371, Suites F, G, & H, Anza, CA 92539 | 2014-01-31 |
| 1316034333 | Rite Time Pharmaceuticals Inc | Pharmacy | 56555 Hwy 371, Anza, CA 92539-0415 | 2006-10-10 |
| 1376744326 | Anza Medical Center | Clinic/Center | 56030 Highway 371, Anza, CA 92539-0799 | 2007-05-29 |
| 1700357845 | Tyler James Anderson | Driver | 39100 Contreras Rd Ste D, Anza, CA 92539-8724 | 2018-12-16 |
| 1659424885 | Riverside-san Bernardino County Indian Health, Inc. | Clinic/Center | 39100 Contreras Rd, Suite C, Anza, CA 92539-8724 | 2007-01-19 |
| 1427474972 | Jennifer Ann Conrad | Nurse Practitioner | 41755 Heller Springs Rd, Anza, CA 92539-8846 | 2014-03-07 |
| 1770936635 | Glenn Petillo | Home Health Aide | 37802 Fischer Rd, Anza, CA 92539-9203 | 2016-07-15 |
| 1093964009 | Susan Crane | Social Worker | 38390 Mcdonald Ln, Anza, CA 92539-9256 | 2008-09-15 |
| 1861602575 | Barrie Helen Abbott | Physician Assistant | 58581 Us Highway 371 Ste F, Ste F, G, H, Anza, CA 92539-9331 | 2007-05-23 |
| Find all providers in zip 92539 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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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.