Organization Active NPI

Coastal Anesthesia Medical Consultants Inc

  • Certified Registered Nurse Anesthetist
  • Cerritos, CA
National Provider Identifier
1306611918
Registry record updated Nov 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
COASTAL ANESTHESIA MEDICAL CONSULTANTS INC
Practice address
11841 South St
Cerritos, CA 90703-6825
Phone
(562) 809-8082
NPI assigned
Nov 24, 2023
Last updated
Nov 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2023

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

Authorized official

Name
Noor-Ul-Ain Fatima Khan, DNAP, CRNANPI 1013627587
Title
Ceo
Phone
(281) 701-4361

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
Certified Registered Nurse Anesthetist 367500000X Primary

Addresses

Primary practice location

11841 South St
Cerritos, CA 90703-6825

Mailing address

16317 Fieldcrest CT
La Mirada, CA 90638-6509

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240102003140 CA Part B Supplier - Clinic/Group Practice 3779933866 Receives reassigned benefits from 1 practitioner
Practice locations: Cerritos, CA

National Provider Directory

National Provider Directory

Locations

11845 South St
Cerritos, CA 90703
Phone (562) 809-2103

Practitioners & affiliated clinicians

Practitioners 2

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": "1700784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700784000000",
    "number": "1306611918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16317 FIELDCREST CT",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906386509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11841 SOUTH ST",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036825",
            "telephone_number": "562-809-8082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL ANESTHESIA MEDICAL CONSULTANTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-24",
        "last_updated": "2023-11-24",
        "certification_date": "2023-11-24",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "NOOR-UL-AIN",
        "authorized_official_middle_name": "FATIMA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "281-701-4361",
        "authorized_official_credential": "DNAP, CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2023; 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.