Healthcare Provider Details

I. General information

NPI: 1891115572
Provider Name (Legal Business Name): JOHN JAMES HOLLOWED JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2014
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24022 CALLE DE LA PLATA STE 500
LAGUNA HILLS CA
92653-7612
US

IV. Provider business mailing address

3080 BRISTOL ST STE 150
COSTA MESA CA
92626-3068
US

V. Phone/Fax

Practice location:
  • Phone: 714-389-1843
  • Fax: 714-445-0245
Mailing address:
  • Phone: 714-389-1843
  • Fax: 714-445-0245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberA142140
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: