MAXWELL JEN (NPI# 1154688810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154688810 |
| Entity Type | Individual |
| Full Name | MAXWELL JEN |
| Credential | MD |
| Practice Address |
17400 Irvine Blvd Ste N Tustin CA 92780-3030 |
| Mailing Address |
24060 Fir Ave Ste A-1 Moreno Valley CA 92553-2895 |
| Practice Telephone | 1111111111 |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2020-09-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | A130209 | CA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 333 City Blvd W, Suite 640, Rt. 128-01, Orange, CA 928682903 | 7144565922 |
| Street Address |
17400 IRVINE BLVD STE N |
| City | TUSTIN |
| State | CA |
| Zip Code | 92780-3030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356955736 | Sentinel Care Medical Group Inc | Clinic/Center | 17400 Irvine Blvd Ste N, Tustin, CA 92780-3030 | 2020-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437780947 | John Michael Michael | Pharmacist | 14481 Wildeve Ln, Tustin, CA 92780 | 2020-02-03 |
| 1609426881 | Abigail Joy Maqsood | Behavior Technician | 290a S Prospect Ave, Tustin, CA 92780 | 2019-09-19 |
| 1255814711 | Hyun Dong Lee | Chiropractor | 14591 Newport Ave Ste 106, Tustin, CA 92780 | 2018-09-11 |
| 1346733573 | Elizabeth Kim Nguyen Dds Inc | Clinic/Center | 14521 Red Hill Ave, Tustin, CA 92780 | 2018-06-12 |
| 1255829503 | Hw Physical Therapy | Physical Therapist | 250 El Camino Real Ste 100, Tustin, CA 92780 | 2018-04-23 |
| 1912494352 | Gary Wayne Mcbeath | Marriage & Family Therapist | 17821 E 17th Street, Suite # 260, Tustin, CA 92780 | 2018-04-20 |
| 1104334598 | Catherine Bogues | Speech-Language Pathologist | 661 West 1st Street, Suite E, Tustin, CA 92780 | 2018-01-19 |
| 1972019941 | Lighthouse Behavioral Solutions | Behavioral Analyst | 18002 Irvine Blvd., Suite 202c, Tustin, CA 92780 | 2017-12-28 |
| 1629597299 | Lifecab, LLC | Non-emergency Medical Transport (VAN) | 13732 Newport Ave, Suite #1, Tustin, CA 92780 | 2017-09-14 |
| 1437606555 | Tustin Speech Therapy, Inc. | Speech-Language Pathologist | 661 West First Street, Suite E, Tustin, CA 92780 | 2016-09-07 |
| Find all providers in zip 92780 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932269156 | Martha Maria Herrero | Emergency Medicine | 15143 Woodlawn Ave, Tustin, CA 92780-6452 | 2006-12-11 |
| 1881641462 | Southern California Acute Care Physicians | Emergency Medicine | 14662 Newport Ave, Tustin, CA 92780-6064 | 2006-05-28 |
| 1255335154 | Philip J. Fagan Jr. | Emergency Medicine | 14642 Newport Ave Ste 101, Tustin, CA 92780-6058 | 2005-06-08 |
| 1780040477 | Tj Tsay Md | Emergency Medicine | 13132 Newport Ave, Suite 200, Tustin, CA 92780-3429 | 2016-01-11 |
| 1386018356 | Can Emergency Physicians Medical Group Inc | Emergency Medicine | 14662 Newport Ave, Tustin, CA 92780-6064 | 2015-11-13 |
| 1144528829 | Robert Amster Md-rancho Penasquitos | Emergency Medicine | 18231 Irvine Blvd, Ste 204, Tustin, CA 92780-3432 | 2011-03-04 |
| 1215235999 | Robert Amster Md-eastlake Inc | Emergency Medicine | 18231 Irvine Blvd, Ste A, Tustin, CA 92780-3432 | 2011-03-04 |
| 1427356104 | Robert Amster Md-utc Inc | Emergency Medicine | 18231 Irvine Blvd, Ste A, Tustin, CA 92780-3432 | 2011-03-04 |
| 1528365731 | Robert Amster Md-grossmont Inc | Emergency Medicine | 18231 Irvine Blvd, Ste 204, Tustin, CA 92780-3432 | 2011-02-24 |
| 1700806981 | Fergus S Ng | Emergency Medicine | 14662 Newport Ave, Tustin, CA 92780-6064 | 2006-07-20 |
| Find all providers in TUSTIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.