KIDS CRITICAL CARE MEDICAL GROUP INC; NPI #1528144763

Contact Information

KIDS CRITICAL CARE MEDICAL GROUP INC

1111 WEST LA PALMA AVE
ANAHEIM MEMORIAL MEDICAL CENTER
ANAHEIM, CA 92801-2881

Phone: 714-999-5144
Fax: 714-999-5143
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Children	282NC2000X	A0[7]	Hospital-Childrenâ€™s (PPS excluded)

Indicates primary specialty

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NPI Profile & details for KIDS CRITICAL CARE MEDICAL GROUP INC

NPI # 1528144763

LBN Legal business name KIDS CRITICAL CARE MEDICAL GROUP INC

Authorized official SANDY SHAW - (PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 10/31/2006

Last updated 08/22/2020 - About 6 years ago

Identifiers

CA	License #	047879
CA	Other	GR0046500	MEDICAL

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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