South Coast Family Medical Center Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

A37009 Issued in CA

Legal business name

SOUTH COAST FAMILY MEDICAL CENTER INC

Practice address

25500 Rancho Niguel Rd Ste 100
Laguna Niguel, CA 92677-7373

Phone

(949) 643-8921

Fax

(949) 643-3914

NPI assigned

Jun 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael Alan Kent, M.D.,NPI 1952335598

Title

Owner

Phone

(949) 643-8921

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 8

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

• Christopher Michael Davis, D.O.

  • Family Medicine Physician
  • Laguna Niguel, CA
  • NPI 1356637813
  Medicare reassignment Care Compare group NPD
• Lauren Kent Davis, D.O.

  • Family Medicine Physician
  • Laguna Niguel, CA
  • NPI 1457647901
  Medicare reassignment Care Compare group NPD
• Michael A. Kent

  • Family Medicine Physician
  • Laguna Niguel, CA
  • NPI 1952335598
  Medicare reassignment NPD Authorized official
• Meredith Derby Harsh, PA

  • Physician Assistant
  • Laguna Hills, CA
  • NPI 1003178534
  Medicare reassignment
• Karen Louise Pollick, RPA-C

  • Physician Assistant
  • Laguna Niguel, CA
  • NPI 1265568497
  NPD
• Jessica Rae Witzmann, PA

  • Medical Physician Assistant
  • Laguna Niguel, CA
  • NPI 1992307235
  NPD
• Norman Coakley, D.O.

  • Family Medicine Physician
  • Laguna Niguel, CA
  • NPI 1801912274
  NPD (past)
• Claire Dellegrotti Liston, APRN ,FNP, AGPCNP-BC

  • Family Nurse Practitioner
  • Irvine, CA
  • NPI 1740726082
  NPD (past)

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1902003791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25500 RANCHO NIGUEL RD STE 100",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926777373",
            "telephone_number": "949-643-8921",
            "fax_number": "949-643-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25500 RANCHO NIGUEL RD STE 100",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926777373",
            "telephone_number": "949-643-8921",
            "fax_number": "949-643-3914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH COAST FAMILY MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "KENT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-643-8921",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.,"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A37009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI  MICHAEL KENT MD",
            "identifier": "1952335598",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS LICENSE",
            "identifier": "A37009",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ26875Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Young Sil Song
• Soraya K. Mahran, DDS, Inc
• South Coast Advanced Imaging
• South Coast Advanced Imaging Inc
• South Coast Dental Specialties
• South Coast Hearing Specialist
• South County Aquatic & Physical Therapy Center, Inc.
• Southern California Acupuncture Inc
• Southern California Sunrise Recovery Center
• Barbara Speare, D.C.

• Clinic/Center in Laguna Niguel, CA
• Providers in Laguna Niguel, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.