Pacific Coast Sports Medicine

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

PACIFIC COAST SPORTS MEDICINE

Practice address

11600 Wilshire Blvd
Suite 522
Los Angeles, CA 90025-5781

Phone

(310) 477-7276

Fax

(310) 477-5148

NPI assigned

Jan 18, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Walter Obrien

Title

President

Phone

(310) 477-7276

Specialties & licenses 8

Addresses

Locations

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326844800000",
    "number": "1083985451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11600 WILSHIRE BLVD",
            "address_2": "SUITE 522",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255781",
            "telephone_number": "310-477-7276",
            "fax_number": "310-477-5148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 WILSHIRE BLVD",
            "address_2": "SUITE 522",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255781",
            "telephone_number": "310-477-7276",
            "fax_number": "310-477-5148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC COAST SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "last_updated": "2012-01-18",
        "status": "A",
        "authorized_official_last_name": "OBRIEN",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-477-7276",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Coast Anesthesia Consultants, Inc.
• Pacific Coast Home Health Services Inc
• Pacific Coast Medical Imaging Inc
• Pacific Coast Medical Supplies
• Pacific Coast Medical Supply
• Pacific Fertility Center
• Pacific Forensic Psychology Associates, Inc
• Pacific Gen LLC
• Pacific Healing Center, Inc.
• Pacific Health Services, Inc.

• Orthopaedic Surgery Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.