NPIMap

Organization Active NPI

North Coast Emergency Physicians

  • Emergency Medicine Physician
  • Fortuna, CA
National Provider Identifier
1992755193
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
NORTH COAST EMERGENCY PHYSICIANS
Practice address
3300 Renner Dr
Fortuna, CA 95540-3120
Phone
(707) 725-7328
NPI assigned
May 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ronald Cordova, M.D.
Title
President
Phone
(707) 725-7328

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

3300 Renner Dr
Fortuna, CA 95540-3120

Mailing address

PO Box 81461
San Diego, CA 92138-1461
Phone (619) 285-5996

Other identifiers 1

IdentifierTypeStateIssuer
GR0042231MedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992755193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 81461",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921381461",
            "telephone_number": "619-285-5996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 RENNER DR",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "955403120",
            "telephone_number": "707-725-7328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COAST EMERGENCY PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CORDOVA",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-725-7328",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0042231",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fortuna, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.