South Coast Medical Group

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

NP 20003 Issued in CA

Legal business name

SOUTH COAST MEDICAL GROUP

Practice address

5 Journey
Suite 130
Aliso Viejo, CA 92656

Phone

(949) 360-1069

Fax

(949) 389-8969

NPI assigned

Jan 4, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Johnna Lynn Gherardini

Title

Executive Director

Phone

(949) 360-1069

Specialties & licenses 1

Addresses

Tax ID family

South Coast Medical Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• South Coast Medical Group

  • Primary Care Clinic/Center
  • Aliso Viejo, CA
  • NPI 1821181538
  NPD tax ID
• South Coast Medical Group Family and Sports Medicine

  • Primary Care Clinic/Center
  • Aliso Viejo, CA
  • NPI 1649337221
  NPD tax ID

Locations

Interoperability endpoints

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

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

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658188800000",
    "number": "1487958518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 JOURNEY",
            "address_2": "SUITE 130",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926565336",
            "telephone_number": "949-360-1069",
            "fax_number": "949-389-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 JOURNEY",
            "address_2": "SUITE 130",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "92656",
            "telephone_number": "949-360-1069",
            "fax_number": "949-389-8969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH COAST MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-04",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A",
        "authorized_official_last_name": "GHERARDINI",
        "authorized_official_first_name": "JOHNNA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "949-360-1069",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "NP 20003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sobertec, LLC
• Ida M Soleimani, DDS
• Khaled Soliman, DMD
• South Coast Dentistry
• South Coast Fertility Lab
• South Coast Medical Group
• South Coast Medical Group Family and Sports Medicine
• South County Healthcare
• Southwest Healthcare Management
• Jessica Shannon Spargur, M. A.

• Primary Care Clinic/Center in Aliso Viejo, CA
• Providers in Aliso Viejo, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.