NPIMap

Organization Active NPI

Coastline Anesthesia & Pain Management Group a Medical Corpora

  • Pain Medicine (Anesthesiology) Physician
  • Huntington Beach, CA
National Provider Identifier
1609046770
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
G75707 Issued in CA
Legal business name
COASTLINE ANESTHESIA & PAIN MANAGEMENT GROUP A MEDICAL CORPORA
Practice address
19572 Elderwood Cir
Huntington Beach, CA 92648-6623
Phone
(714) 743-2406
NPI assigned
Mar 5, 2008
Last updated
Oct 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Authorized official

Name
Dr. Daniel Christopher Bonis, M.D.NPI 1447261136
Title
President
Phone
(714) 743-2406

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X G75707 CA Primary

Addresses

Primary practice location

19572 Elderwood Cir
Huntington Beach, CA 92648-6623

Mailing address

PO Box 218
Orange, CA 92856-6218
Phone (714) 935-0073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081231000269 CA Part B Supplier - Clinic/Group Practice 3779643812 Receives reassigned benefits from 1 practitioner
Practice locations: Paramount, CA

National Provider Directory

National Provider Directory

Locations

1020 S Anaheim Blvd
Ste 306
Anaheim, CA 92805
Phone (714) 743-1406

Practitioners & affiliated clinicians

Practitioners 12

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": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1609046770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 218",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928566218",
            "telephone_number": "714-935-0073",
            "fax_number": "714-935-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19572 ELDERWOOD CIR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926486623",
            "telephone_number": "714-743-2406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTLINE ANESTHESIA & PAIN MANAGEMENT GROUP A MEDICAL CORPORA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-05",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "BONIS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-743-2406",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "G75707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.