South Orange County Gastroenterology Inc

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

A85775 Issued in CA

Legal business name

SOUTH ORANGE COUNTY GASTROENTEROLOGY INC

Practice address

26691 Plaza Ste 150
Mission Viejo, CA 92691-6329

Phone

(949) 348-2900

Fax

(949) 348-0960

NPI assigned

Apr 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Nader Mirhoseni, M.D.NPI 1588645964

Title

President

Phone

(949) 348-2900

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 3

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

• Nader Mirhoseni, M.D.

  • Gastroenterology Physician
  • Mission Viejo, CA
  • NPI 1588645964
  Medicare reassignment NPD Authorized official
• Christina Jenkins, MD

  • Colon & Rectal Surgery Physician
  • Mission Viejo, CA
  • NPI 1881035814
  Medicare reassignment NPD
• Devon Shea McIntosh, NP

  • Nurse Practitioner
  • Long Beach, CA
  • NPI 1790204758
  Medicare reassignment NPD

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1861612293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26691 PLAZA STE 150",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916347",
            "telephone_number": "949-348-2900",
            "fax_number": "949-348-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26691 PLAZA STE 150",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916329",
            "telephone_number": "949-348-2900",
            "fax_number": "949-348-0960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26921 Crown Valley Pkwy",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "926916501",
            "country_code": "US",
            "telephone_number": "949-348-2900",
            "fax_number": "949-348-0960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTH ORANGE COUNTY GASTROENTEROLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "MIRHOSENI",
        "authorized_official_first_name": "NADER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-348-2900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A85775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Coast Community Services
• South County Gastro Medical Clinic PC
• South County Nephrology Consultants Medical Group Inc
• South County Pediatric Speech
• South Orange County Community College District
• South Orange County Hematology Oncology Associates Inc
• South Orange County Orthopaedics, Inc.
• Southern Calfiornia Sunrise Recovery Center
• Southern Calfiornia Sunrise Recovery Center
• Southern Calfiornia Sunrise Recovery Center

• Gastroenterology Physician in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.