NPIMap

Organization Active NPI

Pacific Coast Cardiology Medical Group

  • Cardiovascular Disease Physician
  • Newport Beach, CA
National Provider Identifier
1245284843
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
PACIFIC COAST CARDIOLOGY MEDICAL GROUP
Practice address
3300 W Coast Hwy
Suite a
Newport Beach, CA 92663-4007
Phone
(949) 642-5513
Fax
(949) 646-8223
NPI assigned
May 19, 2006
Last updated
Mar 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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

Authorized official

Name
Dr. Emanuel Shaoulian, M.D.NPI 1194782847
Title
Partner
Phone
(949) 642-5513

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X Primary
Nuclear Medicine Physician 207U00000X

Addresses

Primary practice location

3300 W Coast Hwy
Suite a
Newport Beach, CA 92663-4007

Mailing address

PO Box 6593
Orange, CA 92863-6593
Phone (714) 571-5000

Other identifiers 5

IdentifierTypeStateIssuer
ZZZ02968ZOtherBLUE SHIELD OF CA
GR0083980MedicaidCA
GR0083981MedicaidCA
CI1510OtherRAILROAD MEDICARE
ZZZ56952ZOtherBLUE SHIELD OF CA

National Provider Directory

National Provider Directory

Locations

250 E Yale Loop
Ste A
Irvine, CA 92604
Phone (949) 653-2959

Dept 9484
Los Angeles, CA 90084

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300147200000",
    "number": "1245284843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6593",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928636593",
            "telephone_number": "714-571-5000",
            "fax_number": "714-571-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 W COAST HWY",
            "address_2": "SUITE A",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634007",
            "telephone_number": "949-642-5513",
            "fax_number": "949-646-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC COAST CARDIOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2011-03-15",
        "status": "A",
        "authorized_official_last_name": "SHAOULIAN",
        "authorized_official_first_name": "EMANUEL",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "949-642-5513",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "ZZZ02968Z",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0083980",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0083981",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI1510",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "ZZZ56952Z",
            "state": null
        }
    ],
    "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 Mar 15, 2011; 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.