Southland Advantage Medical Group, Inc.

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Legal business name

SOUTHLAND ADVANTAGE MEDICAL GROUP, INC.

Practice address

5785 Corporate Ave.
Cypress, CA 90630-4726

Phone

(714) 947-8600

NPI assigned

Dec 11, 2009

Last updated

May 16, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Son H. Le, M.D.

Title

President

Phone

(714) 947-8600

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1260489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1689903197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 6300",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906300063",
            "telephone_number": "714-947-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5785 CORPORATE AVE.",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906304726",
            "telephone_number": "714-947-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAND ADVANTAGE MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-11",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "SON",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-947-8600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Manager/Care Coordinator in Cypress, CA
• Providers in Cypress, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; 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.