Organization Active NPI

Nexwave Medical PC

  • Primary Care Clinic/Center
  • Costa Mesa, CA
National Provider Identifier
1639046774
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
NEXWAVE MEDICAL PC
Practice address
745 W 19TH St Ste F
Costa Mesa, CA 92627-3536
Phone
(949) 574-0210
Fax
(949) 574-0220
NPI assigned
Oct 22, 2025
Last updated
Oct 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Authorized official

Name
Elvira Patricia Flores, FNP
Title
Cfo/Secretary
Phone
(562) 682-7683

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

745 W 19TH St Ste F
Costa Mesa, CA 92627-3536

Mailing address

745 W 19TH St Ste F
Costa Mesa, CA 92627-3536
Phone (949) 574-0210

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2340699Nexwave Medical PC745 W 19TH St Suite F, Costa Mesa, CA 92627Certificate of waiverMar 19, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1761091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761091200000",
    "number": "1639046774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 W 19TH ST STE F",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273536",
            "telephone_number": "949-574-0210",
            "fax_number": "949-574-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 W 19TH ST STE F",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273536",
            "telephone_number": "949-574-0210",
            "fax_number": "949-574-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEXWAVE MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-22",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "ELVIRA",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "CFO/SECRETARY",
        "authorized_official_telephone_number": "562-682-7683",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.