NPIMap

Organization Active NPI

Community Outreach Medical Services

  • Community Health Clinic/Center
  • Santa Ana, CA
National Provider Identifier
1487947842
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
A60865 Issued in CA
Legal business name
COMMUNITY OUTREACH MEDICAL SERVICES
Practice address
1200 N. Tustin Ave
Suite 130
Santa Ana, CA 92705-3501
Phone
(657) 600-9077
Fax
(657) 600-9076
NPI assigned
May 18, 2011
Last updated
May 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Authorized official

Name
Jacob Nava Flores, MD
Title
Chief Medical Officer, Cmo
Phone
(760) 809-4045

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X A60865 CA Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

1200 N. Tustin Ave
Suite 130
Santa Ana, CA 92705-3501

Mailing address

2171 S. El Camino Real
Suite 104
Oceanside, CA 92054-6269
Phone (760) 754-5663

Other identifiers 1

IdentifierTypeStateIssuer
A60865OtherCACALIFORNIA MEDICAL LICENSE

National Provider Directory

National Provider Directory

Locations

5520 Santa Monica Blvd
Los Angeles, CA 90038
Phone (323) 860-9054

140 S Lake Ave
#300
Pasadena, CA 91101

1701 E McFadden Ave
Ste D
Santa Ana, CA 92705
Phone (714) 653-6430

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620864000000",
    "number": "1487947842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2171 S. EL CAMINO REAL",
            "address_2": "SUITE 104",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546269",
            "telephone_number": "760-754-5663",
            "fax_number": "760-754-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N. TUSTIN AVE",
            "address_2": "SUITE 130",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053501",
            "telephone_number": "657-600-9077",
            "fax_number": "657-600-9076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY OUTREACH MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-18",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "NAVA",
        "authorized_official_title_or_position": "CHIEF MEDICAL  OFFICER, CMO",
        "authorized_official_telephone_number": "760-809-4045",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": "A60865",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA MEDICAL LICENSE",
            "identifier": "A60865",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.