Coastal Sleep and Diagnostic Center of Orange LLC

Primary specialty

Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X

Legal business name

COASTAL SLEEP AND DIAGNOSTIC CENTER OF ORANGE LLC

Practice address

805 W la Veta Ave Ste 107
Orange, CA 92868-3928

Phone

(714) 790-4070

NPI assigned

Mar 4, 2019

Last updated

Apr 25, 2023By 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

Mr. Bryan Jordan

Title

President

Phone

(714) 790-4070

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

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.

• Ali Salem, M.D.

  • Internal Medicine Physician
  • Montclair, CA
  • NPI 1376983122
  NPD
• Oliver Lee Mason, MD

  • Internal Medicine Physician
  • Cerritos, CA
  • NPI 1871606434
  NPD (past)

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

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1316405897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 W LA VETA AVE STE 107",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W LA VETA AVE STE 107",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683928",
            "telephone_number": "714-790-4070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3325 Palo Verde Ave Ste 207",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908084132",
            "country_code": "US",
            "telephone_number": "714-790-4070",
            "fax_number": "888-751-2479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COASTAL SLEEP AND DIAGNOSTIC CENTER OF ORANGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-04",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-790-4070",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Flordeliza G Clyde
• Carmelita R Co-Casquejo, MD
• Coastal Care Consulting
• Coastal Center for Obesity, Inc
• Coastal Diagnostic Services Inc
• Leonard Hartiz Coaston
• Troy Nicholas Coaston, MD
• Kimberly Yvette Coates
• Tyson Cobb, M.D.
• Melitza J Cobham-Browne, MD

• Sleep Disorder Diagnostic Clinic/Center in Orange, CA
• Providers in Orange, CA by specialty
• Sleep Disorder Diagnostic Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.