Individual provider Active NPI

Christopher Michael Davis, D.O.

  • Family Medicine Physician
  • Laguna Niguel, CA
National Provider Identifier
1356637813
Registry record updated Sep 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A12389 Issued in CA
Practice address
25500 Rancho Niguel Rd
Suite 100
Laguna Niguel, CA 92677-7302
Phone
(949) 643-0500
Fax
(949) 643-3748
NPI assigned
Jun 23, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A12389 CA Primary

Addresses

Primary practice location

25500 Rancho Niguel Rd
Suite 100
Laguna Niguel, CA 92677-7302

Mailing address

25500 Rancho Niguel Rd
Suite 100
Laguna Niguel, CA 92677-7302
Phone (949) 643-0500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140716000393 CA Practitioner - Family Practice 4880819457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Coast Family Medical Center IncGroup PAC ID 4486694320, 2 clinicians

Practice addresses (Care Compare)

25500 Rancho Niguel Rd
Suite 100
Laguna Niguel, CA 92677-7373
Phone 94964305000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A12389CAMDFamily Medicine Physician
12389CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South Coast Family Medical Center Inc CurrentSince Jul 1, 2014 Accepting new patients

Locations

25500 Rancho Niguel Rd
Ste 100
Laguna Niguel, CA 92677
Phone (949) 623-0500

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410393600000",
    "number": "1356637813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25500 RANCHO NIGUEL RD",
            "address_2": "SUITE 100",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926777302",
            "telephone_number": "949-643-0500",
            "fax_number": "949-643-3748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25500 RANCHO NIGUEL RD",
            "address_2": "SUITE 100",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926777302",
            "telephone_number": "949-643-0500",
            "fax_number": "949-643-3748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CHRISTOPHER",
        "middle_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2014-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A12389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Niguel, CA

Sources for this page

Verify at the official NPI Registry.