College Coastal Care LLC

Primary specialty

AmbulanceTaxonomy code 341600000X

License

PENDING Issued in CA

Legal business name

COLLEGE COASTAL CARE LLC

Practice address

1725 Pacific Ave
Long Beach, CA 90813-1714

Phone

(562) 997-2000

NPI assigned

Feb 14, 2018

Organization subpart

No

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

Authorized official

Name

Samantha K. Feld, JD

Title

General Counsel

Phone

(949) 574-3389

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

{
    "created_epoch": "1518566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518566400000",
    "number": "1659871879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11627 TELEGRAPH RD STE 200",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906706814",
            "telephone_number": "949-574-3389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 PACIFIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908131714",
            "telephone_number": "562-997-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGE COASTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-14",
        "last_updated": "2018-02-14",
        "status": "A",
        "authorized_official_last_name": "FELD",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "949-574-3389",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "CA",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulance in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Ambulance in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2018; 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.