Healthcare Provider Details

I. General information

NPI: 1194105429
Provider Name (Legal Business Name): WEST ANAHEIM MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2015
Last Update Date: 06/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3033 W ORANGE AVE
ANAHEIM CA
92804-3156
US

IV. Provider business mailing address

3033 W ORANGE AVE
ANAHEIM CA
92804-3156
US

V. Phone/Fax

Practice location:
  • Phone: 714-827-3000
  • Fax:
Mailing address:
  • Phone: 714-827-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: DR. FARIBORZ SHAMS
Title or Position: GME PROGRAM DIRECTOR
Credential: D.O.
Phone: 714-995-7503