Surgical Group of South Laguna a Medical Corporation

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G059754 Issued in CA

Legal business name

SURGICAL GROUP OF SOUTH LAGUNA A MEDICAL CORPORATION

Practice address

31862 So Coast Hwy
#201
Laguna Beach, CA 92651

Phone

(949) 499-4565

Fax

(949) 499-5265

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

Dr. Steven T Chang, MDNPI 1205048436

Title

President

Phone

(949) 499-4565

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BHIHAA

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Steven T Chang, MD

  • Surgery Physician
  • Laguna Beach, CA
  • NPI 1205048436
  Medicare reassignment Care Compare group Authorized official
• Michael T Coccia, MD

  • Surgery Physician
  • Laguna Beach, CA
  • NPI 1396966495
  Medicare reassignment Care Compare group NPD
• Christopher Young Kang, M.D.

  • Trauma Surgery Physician
  • Laguna Beach, CA
  • NPI 1962715094
  Medicare reassignment NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291593600000",
    "number": "1467550178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31862 SO COAST HWY",
            "address_2": "#201",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "92651",
            "telephone_number": "949-499-4565",
            "fax_number": "949-499-5265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31862 SO COAST HWY",
            "address_2": "#201",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "92651",
            "telephone_number": "949-499-4565",
            "fax_number": "949-499-5265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL GROUP OF SOUTH LAGUNA A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-12-06",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-499-4565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "G059754",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "G084402",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "G059754",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "G084402",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerald Stevens, M.D.
• Jennifer Stocking, NP
• Bobbi Jo Straus, CNOR RNFA
• Jung H. Sung, PA
• Sunshine Behavioral Health LLC (Monarch Shores)
• Trisha Kathleen Sutch, NP
• James Sutherland, M.D.
• Pollyanne Sweitzer, OTD
• Jared John Szymanski, D.O.
• Rinad Taha

• Surgery Physician in Laguna Beach, CA
• Providers in Laguna Beach, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; 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.