Unknown Individual – Critical Care Medicine (Internal Medicine) Physician, NPI 1154313740

Unknown Individual is a healthcare provider. based in Los alamitos, California. specializing in Critical Care Medicine (Internal Medicine) Physician. They hold a License No. G42947 (CA). The NPI Number for Unknown Individual is 1154313740

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1154313740
Phone
(562) 596-7584
Address
3771 KATELLA AVE
Deactivation Date
3 March 2022

Doctor Profile

Medical School Name
NEW YORK UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5625967584
Graduation Year
1979 (47 years ago)
PAC ID
4880584192
Professional Enrollment ID
I20040318001868
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Katella Avenue, Los Alamitos, Orange County, California, 90702, United States

    SUITE #108

    LOS ALAMITOS, CA 907203108

    Phone: (562) 596-7584

    Fax: (562) 596-4360

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 90720)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1154313740 as the unique 10-digit identifier.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Critical Care Medicine (Internal Medicine) Physician. Clinical services aligned with this taxonomy classification.
Where in California is Unknown Individual registered?
Use Los Alamitos, California as the headline location for Unknown Individual here.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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