Provider Demographics
NPI:1194105429
Name:WEST ANAHEIM MEDICAL CENTER
Entity type:Organization
Organization Name:WEST ANAHEIM MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GME PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FARIBORZ
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:714-995-7503
Mailing Address - Street 1:3033 W ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-3156
Mailing Address - Country:US
Mailing Address - Phone:714-827-3000
Mailing Address - Fax:
Practice Address - Street 1:3033 W ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3156
Practice Address - Country:US
Practice Address - Phone:714-827-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital