NPIMap

Organization Active NPI

South Coast Medical Group

  • Primary Care Clinic/Center
  • Aliso Viejo, CA
National Provider Identifier
1821181538
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SOUTH COAST MEDICAL GROUP
Practice address
5 Journey Suite 130
Aliso Viejo, CA 92656
Phone
(949) 360-1069
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Johnna Gherardini, BSBA
Title
Executive Director
Phone
(949) 360-1069

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

5 Journey Suite 130
Aliso Viejo, CA 92656

Mailing address

5 Journey Suite 130
Aliso Viejo, CA 92656
Phone (949) 360-1069

National Provider Directory

National Provider Directory
Tax ID family
South Coast Medical Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821181538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 JOURNEY SUITE 130",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "92656",
            "telephone_number": "949-360-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 JOURNEY SUITE 130",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "92656",
            "telephone_number": "949-360-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH COAST MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GHERARDINI",
        "authorized_official_first_name": "JOHNNA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "949-360-1069",
        "authorized_official_credential": "BSBA"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aliso Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.