THE OPEN TABLE – NPI #1396383022
Clinic/Center

THE OPEN TABLE is an AHC clinic located in COSTA MESA, CA. NPPES has assigned the NPI number 1396383022 to THE OPEN TABLE on December 12, 2019. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QM0801X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Mental Health (Including Community Mental Health Center) Bear in mind that having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for THE OPEN TABLE below.

NPI Profile for
THE OPEN TABLE

NPI Number
1396383022
Enumeration Date

(more than 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
THE OPEN TABLE
Primary location
151 KALMUS DR. BLDG C
SUITE 100
COSTA MESA, CA 92626
Phone: (949) 274-9627 Fax:
Mailing address
1633 E 4TH ST STE 120
SANTA ANA, CA 92701-5143
Phone: (949) 274-9627 Fax:
Organization Subpart
No
Authorized Official
MATTHEW HEIM
DIRECTOR
Phone: (949) 274-9627
Updated
Certification Date
Dec 12, 2019

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM0801X
- Clinic/Center / Mental Health (Including Community Mental Health Center) (Primary)
261QM0855X
- Clinic/Center / Adolescent and Children Mental Health
261QM0850X
- Clinic/Center / Adult Mental Health
261QC1800X
- Clinic/Center / Corporate Health
261QC1500X
- Clinic/Center / Community Health
251V00000X
- Voluntary or Charitable
251S00000X
- Community/Behavioral Health

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.