Provider Demographics
| NPI: | 1598852717 |
|---|---|
| Name: | CHEST AND CRITICAL CARE CONSULTANTS A MEDICAL GROUP |
| Entity type: | Organization |
| Organization Name: | CHEST AND CRITICAL CARE CONSULTANTS A MEDICAL GROUP |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | SR. MANAGING PARTNER |
| Authorized Official - Prefix: | DR |
| Authorized Official - First Name: | DEVANG |
| Authorized Official - Middle Name: | MANUBHAI |
| Authorized Official - Last Name: | SAVANI |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MD |
| Authorized Official - Phone: | 714-836-6800 |
| Mailing Address - Street 1: | PO BOX 15090 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | ANAHEIM |
| Mailing Address - State: | CA |
| Mailing Address - Zip Code: | 92803-5090 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 714-577-2124 |
| Mailing Address - Fax: | 714-577-2125 |
| Practice Address - Street 1: | 1211 W LA PALMA AVE STE 404 |
| Practice Address - Street 2: | |
| Practice Address - City: | ANAHEIM |
| Practice Address - State: | CA |
| Practice Address - Zip Code: | 92801-2806 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 714-772-8282 |
| Practice Address - Fax: | 714-772-6493 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | Yes |
| Parent Organization LBN: | CHEST AND CRITICAL CARE CONSULTANTS A MEDICAL GROUP |
| Parent Organization TIN: | <UNAVAIL> |
| Enumeration Date: | 2006-10-08 |
| Last Update Date: | 2022-03-01 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Single Specialty | |
| No | 207RC0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | Group - Single Specialty |
| No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Single Specialty |
| No | 207RS0012X | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | Group - Multi-Specialty |
| No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Single Specialty | |
| No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
| No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
| No | 363LA2100X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | Group - Multi-Specialty |
| No | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | Group - Multi-Specialty |
| No | 363LC0200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Critical Care Medicine | Group - Multi-Specialty |
| No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |
| No | 363LP2300X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care | Group - Multi-Specialty |
| No | 364SG0600X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Gerontology | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| CA | GR0025650 | Medicaid | |
| CA | GR0025650 | Medicaid |
