Southern California Colon and Rectal Medical Group Inc

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

G79692 Issued in CA

Legal business name

SOUTHERN CALIFORNIA COLON AND RECTAL MEDICAL GROUP INC

Practice address

23961 Calle Magdalena
#231
Laguna Hills, CA 92653

Phone

(949) 609-0500

Fax

(949) 609-0504

NPI assigned

Sep 16, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gene L Syn, MDNPI 1487842720

Title

Ceo/President

Phone

(949) 609-0500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gene Lloyd Syn, M.D.

  • Colon & Rectal Surgery Physician
  • Laguna Hills, CA
  • NPI 1487842720
  Medicare reassignment NPD Authorized official
• Steve Youssefian, M.D.

  • Family Medicine Physician
  • San Dimas, CA
  • NPI 1043698707
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1013013770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23961 CALLE MAGDALENA",
            "address_2": "#231",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "92653",
            "telephone_number": "949-609-0500",
            "fax_number": "949-609-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23961 CALLE MAGDALENA",
            "address_2": "#231",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "92653",
            "telephone_number": "949-609-0500",
            "fax_number": "949-609-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA COLON AND RECTAL MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "SYN",
        "authorized_official_first_name": "GENE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "949-609-0500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": "CA",
            "license": "G79692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Colon & Rectal Surgery Physician in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Colon & Rectal Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.