Individual provider Active NPI

Laurence Michael Fakinos, M.D.

  • Obstetrics & Gynecology Physician
  • Mission Viejo, CA
National Provider Identifier
1376616250
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G67377 Issued in CA
Practice address
27800 Medical Center Rd
Ste. # 260
Mission Viejo, CA 92691-6410
Phone
(949) 364-3050
Fax
(949) 364-2135
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G67377 CA Primary

Addresses

Primary practice location

27800 Medical Center Rd
Ste. # 260
Mission Viejo, CA 92691-6410

Mailing address

27800 Medical Center Rd
Ste. # 260
Mission Viejo, CA 92691-6410
Phone (949) 364-3050

Other identifiers 1

IdentifierTypeStateIssuer
G6737700MedicaidCA

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
I20140626001817 CA Practitioner - Obstetrics/Gynecology 5496979403 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

PO Box
Suite 660
Mammoth Lakes, CA 93546-0660

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G67377CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan Larson MD PC CurrentSince Oct 3, 2023 Accepting new patients
Southern Mono Health Care District CurrentSince Apr 29, 2019 Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients

Locations

2505 Anthem Village Dr
Ste F162
Henderson, NV 89052

Organizations & group practices 3

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 2

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376616250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27800 MEDICAL CENTER RD",
            "address_2": "STE. # 260",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916410",
            "telephone_number": "949-364-3050",
            "fax_number": "949-364-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27800 MEDICAL CENTER RD",
            "address_2": "STE. # 260",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916410",
            "telephone_number": "949-364-3050",
            "fax_number": "949-364-2135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKINOS",
        "first_name": "LAURENCE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G67377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G6737700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.