Individual provider Active NPI

William M Coburn III, D.O.

  • Emergency Medicine Physician
  • Pasadena, CA
National Provider Identifier
1770698920
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A6288 Issued in CA
Practice address
100 W California Blvd
Pasadena, CA 91105-3010
Phone
(626) 397-5106
NPI assigned
Aug 20, 2006
Last updated
Jun 2, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20A6288 CA Primary

Addresses

Primary practice location

100 W California Blvd
Pasadena, CA 91105-3010

Mailing address

100 W California Blvd
Pasadena, CA 91105-3010
Phone (626) 397-5106

Other identifiers 1

IdentifierTypeStateIssuer
00AX62880MedicaidCA

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
I20101122000127 CA Practitioner - Emergency Medicine 3476749128 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HMH Emergency Medical Group, Inc.Group PAC ID 7911800826, 56 clinicians
Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

100 W California Blvd
Pasadena, CA 91105-3010
Phone 6264470296142

26777 Agoura Rd
Suite B4
Calabasas, CA 91302-2967
Phone (818) 880-2225

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A6288CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Exer Medical Corporation CurrentSince Mar 21, 2018 Accepting new patients
HMH Emergency Medical Group, Inc. Emergency Medicine CurrentSince Jan 1, 2001 Accepting new patients
Providence Facey Medical Foundation CurrentSince Feb 11, 2020 Accepting new patients
Providence Facey Medical Foundation CurrentSince Feb 11, 2020 Accepting new patients

Locations (25 of 62)

831 S State College Blvd
Anaheim, CA 92806
Phone (714) 533-2273

242 S Robertson Blvd
Beverly Hills, CA 90211
Phone (310) 652-2300

26777 Agoura Rd
Calabasas, CA 91302
Phone (818) 880-2225

26777 Agoura Rd
Ste 4
Calabasas, CA 91302
Phone (818) 880-2225

26777 Agoura Rd
Ste B4
Calabasas, CA 91302
Phone (818) 880-2225

359 Carmen Dr
Camarillo, CA 93010
Phone (805) 914-5592

235 E 17th St
Costa Mesa, CA 92627
Phone (949) 688-2010

9726 Venice Blvd
Culver City, CA 90232
Phone (310) 202-1300

2381 Rosecrans Ave
Ste 115
El Segundo, CA 90245
Phone (213) 335-7355

390 N Pacific Coast Hwy
Ste 3000
El Segundo, CA 90245
Phone (818) 238-7081

424 W Broadway
Glendale, CA 91204
Phone (818) 796-5396

1365 S Grand Ave
Glendora, CA 91740
Phone (626) 385-1456

7000 Boulder Ave
Ste 103
Highland, CA 92346
Phone (515) 441-6271

2968 E Florence Ave
Huntington Pk, CA 90255
Phone (323) 522-9500

4143 Campus Dr
Ste C200
Irvine, CA 92612
Phone (949) 471-0002

475 Foothill Blvd
La Canada, CA 91011
Phone (818) 528-6377

475 Foothill Blvd
Ste K
La Canada, CA 91011
Phone (818) 528-6377

5101 Lakewood Blvd
Lakewood, CA 90712
Phone (562) 800-3883

16818 Hawthorne Blvd
Lawndale, CA 90260
Phone (310) 370-0317

4200 E Pacific Coast Hwy
Ste 150
Long Beach, CA 90804
Phone (562) 498-1555

11560 W Pico Blvd
Los Angeles, CA 90064
Phone (310) 477-8285

1300 N La Brea Ave
Los Angeles, CA 90028
Phone (323) 464-1336

2090 Westwood Blvd
Los Angeles, CA 90025
Phone (213) 813-4070

269 S San Pedro St
Los Angeles, CA 90012
Phone (213) 947-3600

4121 Santa Monica Blvd
Ste 106
Los Angeles, CA 90029
Phone (213) 335-7355

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1770698920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W CALIFORNIA BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053010",
            "telephone_number": "626-397-5106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W CALIFORNIA BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053010",
            "telephone_number": "626-397-5106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBURN",
        "first_name": "WILLIAM",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A6288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX62880",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.