NPIMap

Organization Active NPI

Glendale Surgical Associates

Doing business as Pacific Coast OMS

  • Oral and Maxillofacial Surgery (Dentist)
  • Glendale, CA
National Provider Identifier
1205090610
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
37945 Issued in CA
Legal business name
GLENDALE SURGICAL ASSOCIATES
Doing business as
Pacific Coast OMS
Practice address
1146 N Brand Blvd
Glendale, CA 91202-2504
Phone
(818) 241-4217
NPI assigned
Jul 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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

Authorized official

Name
Dr. Nam Cho, M.D., D.D.S.
Title
Partner/Owner
Phone
(206) 356-0449

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 37945 CA Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X OMS71 CA
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X OMS94 CA

Addresses

Primary practice location

1146 N Brand Blvd
Glendale, CA 91202-2504

Mailing address

221 E Glenoaks Blvd
Suite #140
Glendale, CA 91207
Phone (818) 241-4217

Other names 1

  • Pacific Coast OMS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Glendale Surgical Associates LP4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524182400000",
    "number": "1205090610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 E GLENOAKS BLVD",
            "address_2": "SUITE #140",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91207",
            "telephone_number": "818-241-4217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1146 N BRAND BLVD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022504",
            "telephone_number": "818-241-4217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDALE SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-15",
        "last_updated": "2018-04-20",
        "status": "A",
        "authorized_official_last_name": "CHO",
        "authorized_official_first_name": "NAM",
        "authorized_official_title_or_position": "PARTNER/OWNER",
        "authorized_official_telephone_number": "206-356-0449",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "37945",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "OMS71",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "OMS94",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Coast OMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; 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.