PRIMARY CARE ASSOCIATES MEDICAL GROUP, INC (NPI# 1073590105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073590105 |
| Entity Type | Organization |
| Organization Name | PRIMARY CARE ASSOCIATES MEDICAL GROUP, INC |
| Other Organization Name | COASTAL ORTHOPAEDICS & SPORTS MEDICAL GROUP |
| Practice Address |
3998 Vista Way Suite B Oceanside CA 92056-4500 |
| Practice Telephone | 7607245173 |
| Practice Fax Number | 7607245265 |
| Mailing Telephone | 7607245173 |
| Mailing Fax Number | 7607245265 |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2008-07-29 |
| Authorized Official Name | MRS. JEANNETTE BRODY (BILLING MANAGER) |
| Authorized Official Telephone | 7607241033 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
A70831 | CA | Allopathic & Osteopathic Physicians |
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
A68137 | CA | Allopathic & Osteopathic Physicians |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
E4564 | CA | Podiatric Medicine & Surgery Service Providers |
| N | 207X00000X | Orthopaedic Surgery | A47884 | CA | Allopathic & Osteopathic Physicians |
| N | 363A00000X | Physician Assistant | PA17120 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207X00000X | Orthopaedic Surgery | A70831 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0089840 | 05 |
| Other Name | Type Code |
|---|---|
| Coastal Orthopaedics & Sports Medical Group | Doing Business As Name - Organization |
| Street Address |
3998 VISTA WAY SUITE B |
| City | OCEANSIDE |
| State | CA |
| Zip Code | 92056-4500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891797023 | Mohammad Jamshidi-nezhad | Surgery | 3998 Vista Way, Suite 200, Oceanside, CA 92056-4500 | 2005-06-01 |
| 1265099295 | Michael L Bonilla | Counselor | 3998 Vista Way, E, Oceanside, CA 92056 | 2019-05-24 |
| 1134696727 | Melissa Marie Morris | Nurse Practitioner | 3998 Vista Way, Oceanside, CA 92056-4500 | 2018-11-01 |
| 1023551256 | Christina Nguyen Liu | Registered Nurse | 3998 Vista Way, Oceanside, CA 92056-4500 | 2016-11-19 |
| 1477929974 | Talal R. Muhtaseb M.d. Inc | Obstetrics & Gynecology | 3998 Vista Way, Suite C, Oceanside, CA 92056 | 2015-08-19 |
| 1801287214 | North Coast Plastic Surgery, Inc. | Plastic Surgery | 3998 Vista Way, Suite A, Oceanside, CA 92056-4500 | 2015-02-08 |
| 1053718460 | Radiance Ob-gyn | Obstetrics & Gynecology | 3998 Vista Way, Suite C, Oceanside, CA 92056-4500 | 2014-12-01 |
| 1457624595 | Adam S. Fierer Md, Inc. | Surgery | 3998 Vista Way, Suite C-200, Oceanside, CA 92056-4500 | 2012-02-21 |
| 1982991030 | Christopher N Crespo | Physician Assistant | 3998 Vista Way, C200, Oceanside, CA 92056-4500 | 2011-07-08 |
| 1578892667 | Robert A Ring | Optometrist | 3998 Vista Way, Oceanside, CA 92056-4500 | 2009-12-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174148639 | Universal Health Net San Diego | Hospice Care, Community Based | 4155 Oceanside Blvd, Suite 240, Oceanside, CA 92056 | 2020-06-10 |
| 1750913216 | Jared Pomerenke | Counselor | 3923 Warning Rd., Suite D, Oceanside, CA 92056 | 2020-02-12 |
| 1700424728 | Donna Jean Trapolino | Dental Hygienist | Bldg414006 Nelson Rd, Camp Pendleton, CA 92056 | 2019-12-20 |
| 1679122717 | David King Ping | Registered Nurse | 3609 Ocean Ranch Blvd Street 104, Oceanside, CA 92056 | 2019-09-11 |
| 1396254058 | Alison Schurman | Nurse Practitioner | 200 Mercy Circle Dr, Department of Pediatrics, Oceanside, CA 92056 | 2017-09-26 |
| 1407212665 | Yolanda Orozco Gaeta | Marriage & Family Therapist | 3923 Waring Road Ste D, North Coastal Treatment Recovery Center, Oceanside, CA 92056 | 2016-01-04 |
| 1871982751 | Wael Wassef | Pharmacist | 4755 Oceanside Blvd Ste 130, Oceanside, CA 92056 | 2015-01-15 |
| 1639501869 | William Stacy Parks | Family Medicine | 2376 Back Nine St., Oceanside, CA 92056 | 2013-07-30 |
| 1760725766 | Great Expectations Services Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4825 Glenhaven Drive, Oceanside, CA 92056 | 2013-03-28 |
| 1649533993 | Justin Bowles | Family Medicine | 1761 Avenida Segovia, Oceanside, CA 92056 | 2012-06-21 |
| Find all providers in zip 92056 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679575344 | David Lee Daugherty | Orthopaedic Surgery | 3905 Waring Rd, Oceanside, CA 92056-4405 | 2005-08-12 |
| 1326515578 | Mount Sinai School of Medicine | Orthopaedic Surgery | 196 Merrick Rd, Oceanside, NY 11572-1420 | 2018-10-25 |
| 1801389614 | Icahn School of Medicine At Mount Sinai | Orthopaedic Surgery | 1 Healthy Way, Oceanside, NY 11572-1551 | 2018-06-07 |
| 1326484403 | Clayton Vaughan | Orthopaedic Surgery | Naval Hospital Camp Pendleton, 200 Mercy Circle, Oceanside, CA 92055-5191 | 2013-05-16 |
| 1366790479 | Morgan Dana Silldorff | Orthopaedic Surgery | 3905 Waring Rd, Oceanside, CA 92056-4405 | 2012-08-21 |
| 1538304704 | Payam Moazzaz | Orthopaedic Surgery | 3905 Waring Rd, Oceanside, CA 92056-4405 | 2008-12-02 |
| 1538329479 | Ryan Joseph Gnandt | Orthopaedic Surgery | 200 Mercy Circle, Camp Pendleton, Oceanside, CA 92055 | 2008-06-13 |
| 1376669572 | Erik Scott Stark | Orthopaedic Surgery | 3905 Waring Rd, Oceanside, CA 92056-4405 | 2007-03-21 |
| 1245345636 | Andrew M Cooperman | Orthopaedic Surgery | 3905 Waring Rd, Oceanside, CA 92056-4405 | 2006-08-19 |
| 1588625982 | Norman Kane | Orthopaedic Surgery | 3905 Waring Rd, Oceanside, CA 92056-4405 | 2006-03-28 |
| Find all providers in OCEANSIDE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.