Advanced Care Medical Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ADVANCED CARE MEDICAL INC

Practice address

400 Newport Center Dr Ste 301
Newport Beach, CA 92660-7604

Phone

(949) 644-1300

Fax

(949) 644-1306

NPI assigned

Jul 27, 2020

Last updated

Jul 27, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Luther Mangoba, MDNPI 1528041894

Title

President

Phone

(951) 640-7822

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

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.

• Luther Mangoba, M.D.

  • Family Medicine Physician
  • Riverside, CA
  • NPI 1528041894
  Medicare reassignment Care Compare group NPD Authorized official
• Jaquolin Eskandr, FNP

  • Family Medicine Physician
  • Riverside, CA
  • NPI 1508219718

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Michele Lorraine Martinez, MD.

  • Family Medicine Physician
  • Riverside, CA
  • NPI 1205939204
  NPD
• Suzanne Roy, FNP

  • Family Nurse Practitioner
  • Newport Beach, CA
  • NPI 1265271399
  NPD

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595808000000",
    "number": "1821607789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 NEWPORT CENTER DR STE 301",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607604",
            "telephone_number": "951-640-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NEWPORT CENTER DR STE 301",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607604",
            "telephone_number": "949-644-1300",
            "fax_number": "949-644-1306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CARE MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-27",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A",
        "authorized_official_last_name": "MANGOBA",
        "authorized_official_first_name": "LUTHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-640-7822",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohammad Adl, RPH
• Carl Matthew Adler
• Zachary B Adler, MD
• Adr Optometric Group
• Adrienne E. Pasek, Professional Psychological Corporation (Dr. Adrienne E. Pasek)
• Advanced Practice Services
• Advanced Skincare Medcenter Inc.
• Advanced Skincare Surgery Center
• Advanced Surgical Center of Newport Beach, LLC
• Advanced Surgical Ctr of Newport Beach

• Family Medicine Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.