Summit Coastal Living

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

C50412 Issued in CA

Legal business name

SUMMIT COASTAL LIVING

Practice address

165 E Wilson St # B
Costa Mesa, CA 92627-1564

Phone

(949) 689-8880

NPI assigned

Mar 29, 2016

Last updated

Mar 29, 2016By 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

Mr. Keith B RandleNPI 1285001438

Title

President

Phone

(949) 689-8880

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Keith Randle

  • Clinical Medical Laboratory
  • Newport Beach, CA
  • NPI 1285001438
  Authorized official Same address or phone

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459209600000",
    "number": "1831552850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2028",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926591028",
            "telephone_number": "949-689-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 E WILSON ST # B",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926271564",
            "telephone_number": "949-689-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT COASTAL LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-29",
        "last_updated": "2016-03-29",
        "status": "A",
        "authorized_official_last_name": "RANDLE",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-689-8880",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "C50412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karly Lyn Sukut-Neppl, D.D.S.
• Paul Sullivan, PSY.D.
• Steven Mark Sultanoff, PH.D.
• Michaela Summers
• Terra Summers, L.AC.
• Reyna Sun
• Tao Te Sun, D.D.S.
• Sundine Center for Facial Aesthetics and Plastic Surgery Inc
• Sunflower Surgical Institute, LLC
• Olivia Christine Sung

• Substance Abuse Rehabilitation Facility in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.