Coachcare Mso LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

COACHCARE MSO LLC

Practice address

1246 19TH St
Hermosa Beach, CA 90254-3308

Phone

(917) 324-9942

NPI assigned

Jan 6, 2025

Organization subpart

No

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

Authorized official

Name

Lisa Lorella

Title

VP Strategy

Phone

(917) 336-1205

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Justin Richard Allen

  • Emergency Medicine Physician
  • Tifton, GA
  • NPI 1952545550
  NPD (past)

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

{
    "created_epoch": "1736121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736121600000",
    "number": "1124837828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E 43RD ST FL 7250",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100174707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1246 19TH ST",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902543308",
            "telephone_number": "917-324-9942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COACHCARE MSO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-06",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A",
        "authorized_official_last_name": "LORELLA",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "VP STRATEGY",
        "authorized_official_telephone_number": "917-336-1205"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine L Spryer
• Noel Lee Chun, M.D.
• Analisa Church, MA, CCC-SLP
• City of Hermosa Beach
• Steven Clark
• Coast Chiropractic Center
• Coastal Mindscape Nursing Corporation
• Coastline Surgery Center of California PC
• Coastline Surgery Center of California PC
• Theodore V Cohen, LMFT

• Internal Medicine Physician in Hermosa Beach, CA
• Providers in Hermosa Beach, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.