Unknown Individual – Family Medicine Physician, NPI 1508874645

Unknown Individual is a healthcare provider. based in Garden grove, California. specializing in Family Medicine Physician. They hold a License No. A34383 (CA). The NPI Number for Unknown Individual is 1508874645

Main info

Organization
Inactive
56 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1508874645
Phone
(714) 899-2000
Address
9191 WESTMINSTER AVE
Deactivation Date
14 April 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7148992000
Graduation Year
1970 (56 years ago)
PAC ID
6608967294
Group Practice PAC ID
2466687728
Professional Enrollment ID
I20070810000766
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

  • Westminster Avenue, Garden Grove, Orange County, California, 98843, United States

    GARDEN GROVE, CA 928442751

    Phone: (714) 899-2000

    Fax: (714) 899-0051

    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.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

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 92844)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2466687728View full group profile
NameSpecialtyState
Family PracticeCA
Nurse PractitionerCA
Family PracticeCA
Osteopathic Manipulative MedicineCA
Internal MedicineCA
Physician AssistantCA
Internal MedicineCA
-CA
Family PracticeCA

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1508874645; it appears in the national provider directory.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Garden Grove, California for Unknown Individual; download NPPES for the complete set.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1508874645. Always confirm identity and privileges with the practice and licensing boards.

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