NPIMap

Organization Active NPI

Paul J. Cimoch II, MD, a Professional Corp

  • Internal Medicine Physician
  • Costa Mesa, CA
National Provider Identifier
1356472344
Registry record updated Aug 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A546088 Issued in CA
Legal business name
PAUL J. CIMOCH II, MD, A PROFESSIONAL CORP
Doing business as
Center for Special Immunology
Practice address
1503 S Coast Dr
Suite 111
Costa Mesa, CA 92626-1534
Phone
(714) 206-6868
Fax
(714) 429-1685
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2011

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

Authorized official

Name
Dr. Paul J Cimoch, M.D.NPI 1093793853
Title
President
Phone
(714) 206-6868

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
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A546088 CA Primary

Addresses

Primary practice location

1503 S Coast Dr
Suite 111
Costa Mesa, CA 92626-1534

Mailing address

1503 S Coast Dr
Suite 111
Costa Mesa, CA 92626-1534
Phone (714) 206-6868

Other identifiers 1

IdentifierTypeStateIssuer
GR0066170MedicaidCA

Other names 1

  • Center for Special Immunology Doing business as

National Provider Directory

National Provider Directory

Locations

1503 S Coast Dr
Ste 111
Costa Mesa, CA 92626
Phone (714) 206-6868

11160 Warner Ave
Ste 419
Fountain Vly, CA 92708
Phone (714) 751-5800

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312416000000",
    "number": "1356472344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 S COAST DR",
            "address_2": "SUITE 111",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261534",
            "telephone_number": "714-206-6868",
            "fax_number": "714-429-1685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 S COAST DR",
            "address_2": "SUITE 111",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261534",
            "telephone_number": "714-206-6868",
            "fax_number": "714-429-1685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL J. CIMOCH II, MD, A PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2011-08-04",
        "status": "A",
        "authorized_official_last_name": "CIMOCH",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-206-6868",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A546088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0066170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Special Immunology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; 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.