South County Healthcare

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

20A6613 Issued in CA

Legal business name

SOUTH COUNTY HEALTHCARE

Practice address

125 Columbia
A
Aliso Viejo, CA 92656-4101

Phone

(949) 388-3131

Fax

(949) 429-0623

NPI assigned

Sep 30, 2015

Last updated

Sep 30, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Paul Robert Addison, P.T.

Title

Vice President

Phone

(949) 388-3131

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443571200000",
    "number": "1265802557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 COLUMBIA",
            "address_2": "A",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926564101",
            "telephone_number": "949-388-3131",
            "fax_number": "949-429-0623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 COLUMBIA",
            "address_2": "A",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926564101",
            "telephone_number": "949-388-3131",
            "fax_number": "949-429-0623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH COUNTY HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-30",
        "last_updated": "2015-09-30",
        "status": "A",
        "authorized_official_last_name": "ADDISON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "949-388-3131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CA",
            "license": "20A6613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Aliso Viejo, CA
• Providers in Aliso Viejo, CA by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; 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.