NPIMap

Organization Active NPI

Coast Medical, PC

  • Psychiatry Physician
  • Anaheim, CA
National Provider Identifier
1780435628
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
COAST MEDICAL, PC
Practice address
1720 W Ball Rd Ste 4C
Anaheim, CA 92804-5591
Phone
(626) 429-0088
NPI assigned
Mar 28, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Authorized official

Name
Jackson TeaNPI 1477365997
Title
VP/Board of Director
Phone
(626) 429-0088

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X
Geriatric Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0805X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X

Addresses

Primary practice location

1720 W Ball Rd Ste 4C
Anaheim, CA 92804-5591

Mailing address

532 N Magnolia Ave # 769
Anaheim, CA 92801-4937
Phone (714) 683-1472

Other practice location 1

5871 Pine Ave Ste 120
Chino Hills, CA 91709-6545
Phone (714) 683-1472

Other practice location 2

1800 Wilshire Blvd
Los Angeles, CA 90057-3602
Phone (714) 683-1472

Other names 3

  • Orange Coast Psychiatry Doing business as
  • Orange Coast Psychiatry, Medical Corporation Doing business as
  • BJE Esterman PC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240830003581 CA Part B Supplier - Clinic/Group Practice 2062951205 Receives reassigned benefits from 23 practitioners
Practice locations: Anaheim, CA; Chino Hills, CA; Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

5871 Pine Ave
Ste 120
Chino Hills, CA 91709
Phone (714) 683-1472

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772496000000",
    "number": "1780435628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 N MAGNOLIA AVE # 769",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928014937",
            "telephone_number": "714-683-1472",
            "fax_number": "714-683-1473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 W BALL RD STE 4C",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928045591",
            "telephone_number": "626-429-0088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5871 Pine Ave Ste 120",
            "address_purpose": "LOCATION",
            "city": "Chino Hills",
            "state": "CA",
            "postal_code": "917096545",
            "country_code": "US",
            "telephone_number": "714-683-1472",
            "fax_number": "714-683-1473",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 Wilshire Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900573602",
            "country_code": "US",
            "telephone_number": "714-683-1472",
            "fax_number": "714-683-1473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COAST MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-28",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A",
        "authorized_official_last_name": "TEA",
        "authorized_official_first_name": "JACKSON",
        "authorized_official_title_or_position": "VP/BOARD OF DIRECTOR",
        "authorized_official_telephone_number": "626-429-0088"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orange Coast Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Orange Coast Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Orange Coast Psychiatry, Medical Corporation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BJE Esterman PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2026; 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.