Organization
CENTRAL COUNTY CHEST MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY AGUIRRE (OFFICE MANAGER)
(714) 979-2825
Entity
Organization
Contact information
Practice address
11180 WARNER AVE STE 253, FOUNTAIN VALLEY, CA 92708-7515
(714) 979-2825
(714) 979-2862
Mailing address
11180 WARNER AVE STE 253, FOUNTAIN VALLEY, CA 92708-7515
(714) 979-2825
(714) 979-2862
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A42385
CA
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
A43693
CA
207RP1001X
Pulmonary Disease Physician
A42385
CA
207RP1001X
Pulmonary Disease Physician
A43693
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A42385
STATE LIC
CA
01
—
A43693
STATE LIC
CA
01
—
GR0053330
CAL-OPTIMA
CA
01
—
W11174
MEDICARE GROUP NUMBER
CA
01
—
ZZZ33736Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
07/11/2006
Last updated
08/13/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us