Organization Active NPI

Oc Surgical Support LLC

  • General Practice Physician
  • Newport Beach, CA
National Provider Identifier
1104698638
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
OC SURGICAL SUPPORT LLC
Practice address
4501 Birch St Ste 101a
Newport Beach, CA 92660-1990
Phone
(310) 543-7779
Fax
(844) 386-5090
NPI assigned
Oct 27, 2023
Last updated
Jan 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Authorized official

Name
David E Carry, DCNPI 1497088074
Title
Manager
Phone
(310) 543-7779

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

4501 Birch St Ste 101a
Newport Beach, CA 92660-1990

Mailing address

1231 Cabrillo Ave Ste 205
Torrance, CA 90501-2867
Phone (310) 543-7779

National Provider Directory

National Provider Directory

Locations

4501 Birch St
Ste 101A
Newport Beach, CA 92660
Phone (310) 543-7779

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1698364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704326400000",
    "number": "1104698638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 CABRILLO AVE STE 205",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905012867",
            "telephone_number": "310-543-7779",
            "fax_number": "844-386-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 BIRCH ST STE 101A",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601990",
            "telephone_number": "310-543-7779",
            "fax_number": "844-386-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OC SURGICAL SUPPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-27",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A",
        "authorized_official_last_name": "CARRY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "310-543-7779",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; 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.