BROAD REACH SPECIALTY SURGERY INC – NPI #1568971869
Radiology

A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.

Health Care Provider Taxonomy Code for Radiology

BROAD REACH SPECIALTY SURGERY INC is a radiologist located in IRVINE, CA. NPPES has assigned the NPI number 1568971869 to BROAD REACH SPECIALTY SURGERY INC on September 29, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 2085R0204X from the Health Care Provider Taxonomy code set, which is classified as Radiology, specializing in Vascular & Interventional Radiology

The NPI profile was last updated on Apr 07, 2025. 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 BROAD REACH SPECIALTY SURGERY INC below.

NPI Profile for
BROAD REACH SPECIALTY SURGERY INC

NPI Number
1568971869
Enumeration Date

(more than 8 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
BROAD REACH SPECIALTY SURGERY INC
Primary location
1400 REYNOLDS AVE STE 200
IRVINE, CA 92614-5563
Phone: (949) 387-4724 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JOHN HEWETT
PRESIDENT
Phone: (949) 387-4724
Updated
Certification Date
Apr 07, 2025

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
2085R0204X
- Radiology / Vascular & Interventional Radiology (Primary)

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.