Southern California Riviera

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

Legal business name

SOUTHERN CALIFORNIA RIVIERA

Practice address

24411 Health Center Dr
Ste 560
Laguna Hills, CA 92653-3651

Phone

(949) 452-0061

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Fady Kadifa, M.D.NPI 1083711014

Title

President

Phone

(949) 452-0061

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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

• Fady Kadifa, M.D.

  • Pulmonary Disease Physician
  • Laguna Hills, CA
  • NPI 1083711014
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358121600000",
    "number": "1376640417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24411 HEALTH CENTER DR STE 560",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24411 HEALTH CENTER DR",
            "address_2": "STE 560",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533651",
            "telephone_number": "949-452-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA RIVIERA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-01-14",
        "status": "A",
        "authorized_official_last_name": "KADIFA",
        "authorized_official_first_name": "FADY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-452-0061",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A508220",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DC4641",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Brianna Marie Southworth
• Holly Marie Spanggord, M.D.

• Pulmonary Disease Physician in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Pulmonary Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; 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.