NPIMap

Organization Active NPI

South Coast Emergency Medical Group

  • Emergency Medicine Physician
  • Anaheim, CA
National Provider Identifier
1831294594
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
SOUTH COAST EMERGENCY MEDICAL GROUP
Practice address
3033 West Orange Avenue
Anaheim, CA 92804
Phone
(714) 827-3000
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Authorized official

Name
David A Reid, MDNPI 1053378380
Title
Director
Phone
(562) 809-3570

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

3033 West Orange Avenue
Anaheim, CA 92804

Mailing address

PO Box 4419
Woodland Hills, CA 91365-4419
Phone (818) 340-9988

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ82235ZMedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040803001437 CA Part B Supplier - Clinic/Group Practice 8628049608 Receives reassigned benefits from 43 practitioners
Practice locations: Anaheim, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184025600000",
    "number": "1831294594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4419",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913654419",
            "telephone_number": "818-340-9988",
            "fax_number": "818-587-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 WEST ORANGE AVENUE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "92804",
            "telephone_number": "714-827-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH COAST EMERGENCY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-10",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "562-809-3570",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ82235Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jul 10, 2007; 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.