Organization Active NPI

Obstetrix Medical Group of the Central Coast Professional Corporation

  • Maternal & Fetal Medicine Physician
  • Orange, CA
National Provider Identifier
1790970416
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
Legal business name
OBSTETRIX MEDICAL GROUP OF THE CENTRAL COAST PROFESSIONAL CORPORATION
Practice address
770 The City Dr S Ste 4000
Orange, CA 92868-4929
Phone
(800) 243-3839
NPI assigned
Sep 6, 2007
Last updated
Oct 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Authorized official

Name
Nanette Sanders
Title
Assistant Secretary
Phone
(800) 243-3839

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X Primary

Addresses

Primary practice location

770 The City Dr S Ste 4000
Orange, CA 92868-4929

Mailing address

1301 Concord Ter
Sunrise, FL 33323-2843
Phone (800) 243-3839

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090602000596 CA Part B Supplier - Clinic/Group Practice 8527118157 Receives reassigned benefits from 14 practitioners
Practice locations: Van Nuys, CA; West Hills, CA; Ventura, CA; Thousand Oaks, CA; Santa Barbara, CA; Oxnard, CA; Northridge, CA

National Provider Directory

National Provider Directory

Locations

1911 Johnson Ave
#103
San Luis Obispo, CA 93401
Phone (805) 546-2057

427 W Pueblo St
Ste A
Santa Barbara, CA 93105
Phone (805) 687-7336

210 S Palisade Dr
Ste 103
Santa Maria, CA 93454
Phone (805) 928-5645

2100 Lynn Rd
Ste 125
Thousand Oaks, CA 91360
Phone (805) 375-7900

6850 Sepulveda Blvd
Ste 207
Van Nuys, CA 91405
Phone (805) 777-7406

100 N Brent St
Ste 100
Ventura, CA 93003
Phone (805) 643-9022

29 N Brent St
Ventura, CA 93003
Phone (805) 643-9781

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1790970416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 CONCORD TER",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232843",
            "telephone_number": "800-243-3839",
            "fax_number": "714-740-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 THE CITY DR S STE 4000",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684929",
            "telephone_number": "800-243-3839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBSTETRIX MEDICAL GROUP OF THE CENTRAL COAST PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-06",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "NANETTE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "800-243-3839"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.