NPIMap

Organization Active NPI

Community Outreach Medical Service

  • Family Medicine Physician
  • Santa Ana, CA
National Provider Identifier
1295078376
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
GM702A Issued in CA
Legal business name
COMMUNITY OUTREACH MEDICAL SERVICE
Practice address
1701 E McFadden Ave
Unit D
Santa Ana, CA 92705-4647
Phone
(323) 298-1668
NPI assigned
Mar 27, 2013
Organization subpart
Yes
Parent organization
COMMUNITY OUTREACH MEDICAL SERVICEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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

Authorized official

Name
Melvin Smith
Title
Ceo
Phone
(951) 695-9648

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X GM702A CA Primary

Addresses

Primary practice location

1701 E McFadden Ave
Unit D
Santa Ana, CA 92705-4647

Mailing address

4300 Crenshaw Blvd
Los Angeles, CA 90008-4902
Phone (323) 298-1668

National Provider Directory

National Provider Directory
Tax ID family
Community Outreach Medical Service3 organizations share this tax ID, including this one
Part of
Community Outreach Medical Service

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1295078376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900084902",
            "telephone_number": "323-298-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E MCFADDEN AVE",
            "address_2": "UNIT D",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927054647",
            "telephone_number": "323-298-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY OUTREACH MEDICAL SERVICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY OUTREACH MEDICAL SERVICE",
        "enumeration_date": "2013-03-27",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-695-9648"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "GM702A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.