Organization Active NPI

Personalcare Physicians of Newport Beach Inc

  • Family Medicine Physician
  • Corona del Mar, CA
National Provider Identifier
1740484633
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PERSONALCARE PHYSICIANS OF NEWPORT BEACH INC
Practice address
2121 E Coast Hwy Ste 250
Corona del Mar, CA 92625-1932
Phone
(949) 706-3300
Fax
(949) 706-3301
NPI assigned
Jun 13, 2007
Last updated
Nov 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Authorized official

Name
Kenneth S. Cheng
Title
Physician
Phone
(949) 706-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2121 E Coast Hwy Ste 250
Corona del Mar, CA 92625-1932

Mailing address

2121 E Coast Hwy Ste 250
Corona del Mar, CA 92625-1932
Phone (949) 706-3300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200324001785 CA Part B Supplier - Clinic/Group Practice 4587092663 Receives reassigned benefits from 2 practitioners
Practice locations: Corona del Mar, CA

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

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": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635897600000",
    "number": "1740484633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 E COAST HWY STE 250",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926251932",
            "telephone_number": "949-706-3300",
            "fax_number": "949-706-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 E COAST HWY STE 250",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926251932",
            "telephone_number": "949-706-3300",
            "fax_number": "949-706-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONALCARE PHYSICIANS OF NEWPORT BEACH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A",
        "authorized_official_last_name": "CHENG",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "949-706-3300"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona del Mar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; 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.