Individual provider Active NPI

Stephen S Ehrlich, M.D.

  • Cardiovascular Disease Physician
  • Mission Viejo, CA
National Provider Identifier
1700862547
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
G58587 Issued in CA
Practice address
27800 Medical Center Rd
Suite 222
Mission Viejo, CA 92691-6410
Phone
(949) 276-2446
Fax
(949) 276-2449
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X G58587 CA
Cardiovascular Disease Physician 207RC0000X G58587 CA Primary

Addresses

Primary practice location

27800 Medical Center Rd
Suite 222
Mission Viejo, CA 92691-6410

Mailing address

27800 Medical Center Rd
Suite 222
Mission Viejo, CA 92691-6410
Phone (949) 276-2446

Other identifiers 1

IdentifierTypeStateIssuer
00G585870MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050128000949 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Cardiac Electrophysiology 2769432566 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G58587CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ccoc, Inc. Clinical Cardiac Electrophysiology CurrentSince Jan 1, 2010 Accepting new patients
Mission Internal Medical Group, Inc. Current Accepting new patients
Pacific Private Practice Network Inc Past Accepting new patients

Locations

333 Corporate Dr
Ste 102
Mission Viejo, CA 92694
Phone (949) 276-2446

27800 Medical Center Rd
Ste 222
Mission Viejo, CA 92691
Phone (949) 276-2446

26522 La Alameda
Ste 120
Mission Viejo, CA 92691
Phone (949) 282-1671

665 Camino de los Mares
Ste 210
San Clemente, CA 92673
Phone (949) 240-6772

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1700862547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27800 MEDICAL CENTER RD",
            "address_2": "SUITE 222",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916410",
            "telephone_number": "949-276-2446",
            "fax_number": "949-276-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27800 MEDICAL CENTER RD",
            "address_2": "SUITE 222",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916410",
            "telephone_number": "949-276-2446",
            "fax_number": "949-276-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHRLICH",
        "first_name": "STEPHEN",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "CA",
            "license": "G58587",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G58587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G585870",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.