NPIMap

Organization Active NPI

Share Our Selves Corporation

Doing business as SOS Mobile Health Unit

  • Federally Qualified Health Center (FQHC)
  • Costa Mesa, CA
National Provider Identifier
1821612128
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SHARE OUR SELVES CORPORATION
Doing business as
SOS Mobile Health Unit
Practice address
1550 Superior Ave
Costa Mesa, CA 92627-3653
Phone
(949) 270-2100
NPI assigned
Jun 2, 2020
Last updated
Jun 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

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

Authorized official

Name
Christy Ward
Title
Chief Executive Officer
Phone
(949) 536-3927

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1550 Superior Ave
Costa Mesa, CA 92627-3653

Mailing address

PO Box 10159
Costa Mesa, CA 92627-0050

Other names 1

  • SOS Mobile Health Unit Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Share Our Selves Corporation10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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": "1591056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591056000000",
    "number": "1821612128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10159",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926270050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 SUPERIOR AVE",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273653",
            "telephone_number": "949-270-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHARE OUR SELVES CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-02",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "949-536-3927"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOS Mobile Health Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.