Ocean Breeze Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A065157 Issued in CA

Legal business name

OCEAN BREEZE MEDICAL GROUP, INC.

Practice address

150 Avenida Cabrillo Ste a
San Clemente, CA 92672-5595

Phone

(949) 369-6993

NPI assigned

Jan 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Ricardo Davalos, M.D.NPI 1609804749

Title

Owner

Phone

(949) 369-6993

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Ricardo Davalos, M.D.

  • Family Medicine Physician
  • San Clemente, CA
  • NPI 1609804749
  Medicare reassignment NPD Authorized official
• Shari Sharp, P.A.

  • Surgical Physician Assistant
  • Newport Beach, CA
  • NPI 1285664458
  Medicare reassignment

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292198400000",
    "number": "1386790400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 AVENIDA CABRILLO STE A",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926725595",
            "telephone_number": "949-369-6993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 AVENIDA CABRILLO STE A",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926725595",
            "telephone_number": "949-369-6993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCEAN BREEZE MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2010-12-13",
        "status": "A",
        "authorized_official_last_name": "DAVALOS",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-369-6993",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A065157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Jett O'Connor, M.S. CCC-SLP
• Alison Eileen O'Leary
• Obaidi Dental Corporation
• Anmar Obaidi, D.D.S.
• Oc Couple and Family Therapy
• Ocean Physical Therapy, Inc.
• Oceans Luxury Rehab
• Rachel Anne Okonski, P.T.
• Allison Olex, DDS
• Jessica Olson

• Family Medicine Physician in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.