NPIMap

Organization Active NPI

Optimum Wellness and Weight Loss

Doing business as Optimum Rejuvenation

  • Clinic/Center
  • San Clemente, CA
National Provider Identifier
1225636855
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
OPTIMUM WELLNESS AND WEIGHT LOSS
Doing business as
Optimum Rejuvenation
Practice address
910 S El Camino Real Ste 100
San Clemente, CA 92672-4279
Phone
(949) 363-3162
Fax
(888) 408-8262
NPI assigned
Oct 15, 2020
Last updated
Oct 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Authorized official

Name
Dr. Sunao Gilbert, MD, FAARFMNPI 1699706127
Title
Owner
Phone
(949) 363-3162

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
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

910 S El Camino Real Ste 100
San Clemente, CA 92672-4279

Mailing address

638 Camino de Los Mares # H130-103
San Clemente, CA 92673-2848
Phone (310) 595-0679

Other names 1

  • Optimum Rejuvenation Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL drgilbert@rejuvenatechu.com

National Provider Directory

National Provider Directory

Locations

638 Camino de los Mares
#H130103
San Clemente, CA 92673

Practitioners & affiliated clinicians

Practitioners 1

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": "1602720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602720000000",
    "number": "1225636855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 CAMINO DE LOS MARES # H130-103",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732848",
            "telephone_number": "310-595-0679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 S EL CAMINO REAL STE 100",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724279",
            "telephone_number": "949-363-3162",
            "fax_number": "888-408-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM WELLNESS AND WEIGHT LOSS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-15",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A",
        "authorized_official_last_name": "GILBERT",
        "authorized_official_first_name": "SUNAO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-363-3162",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, FAARFM"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "drgilbert@rejuvenatechu.com",
            "affiliation": "N",
            "address_1": "910 S El Camino Real Ste 100",
            "city": "San Clemente",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926724279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Optimum Rejuvenation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; 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.