Organization Active NPI

Southern Orange County Pediatric Associates, Inc.

  • Pediatrics Physician
  • Lake Forest, CA
National Provider Identifier
1881643021
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SOUTHERN ORANGE COUNTY PEDIATRIC ASSOCIATES, INC.
Practice address
23321 El Toro Rd
Suites F&G
Lake Forest, CA 92630-4825
Phone
(949) 770-6789
Fax
(949) 829-9125
NPI assigned
May 7, 2006
Last updated
Jan 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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

Authorized official

Name
Melanie Jackson
Title
Practice Administrator
Phone
(949) 770-6789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X CA Primary

Addresses

Primary practice location

23321 El Toro Rd
Suites F&G
Lake Forest, CA 92630-4825

Mailing address

23321 El Toro Rd
Suites F&G
Lake Forest, CA 92630-4825
Phone (949) 770-6789

National Provider Directory

National Provider Directory

Locations

23321 El Toro Rd
Ste Fg
Lake Forest, CA 92630
Phone (949) 770-0513

23672 Birtcher Dr
Lake Forest, CA 92630
Phone (949) 770-7301

29941 Aventura
Ste F
Rancho Santa Margarita, CA 92688

30212 Tomas
Ste 202
Rancho Santa Margarita, CA 92688

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1146960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358467200000",
    "number": "1881643021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23321 EL TORO RD",
            "address_2": "SUITES F&G",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926304825",
            "telephone_number": "949-770-6789",
            "fax_number": "949-829-9125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23321 EL TORO RD",
            "address_2": "SUITES F&G",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926304825",
            "telephone_number": "949-770-6789",
            "fax_number": "949-829-9125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ORANGE COUNTY PEDIATRIC ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-07",
        "last_updated": "2013-01-18",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "949-770-6789"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; 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.