NPIMap

Organization Active NPI

Ccoc, Inc.

Doing business as Coastal Cardiology of Orange County

  • Clinical Cardiac Electrophysiology Physician
  • Ladera Ranch, CA
National Provider Identifier
1285968909
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
G58587 Issued in CA
Legal business name
CCOC, INC.
Doing business as
Coastal Cardiology of Orange County
Practice address
333 Corporate Dr Ste 102
Ladera Ranch, CA 92694-2113
Phone
(949) 276-2446
Fax
(949) 276-2449
NPI assigned
Sep 28, 2009
Last updated
Mar 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

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

Authorized official

Name
Dr. Stephen S Ehrlich, MDNPI 1700862547
Title
Owner
Phone
(949) 276-2446

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X G58587 CA Primary

Addresses

Primary practice location

333 Corporate Dr Ste 102
Ladera Ranch, CA 92694-2113

Mailing address

333 Corporate Dr Ste 102
Ladera Ranch, CA 92694-2113
Phone (949) 276-2446

Other identifiers 1

IdentifierTypeStateIssuer
00G585870MedicaidCA

Other names 1

  • Coastal Cardiology of Orange County Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100120000720 CA Part B Supplier - Clinic/Group Practice 0840332474 Receives reassigned benefits from 5 practitioners
Practice locations: Ladera Ranch, CA

National Provider Directory

National Provider Directory

Locations

16305 Sand Canyon Ave
Ste 255
Irvine, CA 92618
Phone (949) 443-4303

333 Corporate Dr
Ste 102
Mission Viejo, CA 92694
Phone (949) 276-2446

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 7

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": "1254096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583884800000",
    "number": "1285968909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CORPORATE DR STE 102",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926942113",
            "telephone_number": "949-276-2446",
            "fax_number": "949-276-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 CORPORATE DR STE 102",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926942113",
            "telephone_number": "949-276-2446",
            "fax_number": "949-276-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCOC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-28",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A",
        "authorized_official_last_name": "EHRLICH",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-276-2446",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "CA",
            "license": "G58587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G585870",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Cardiology of Orange County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ladera Ranch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.