COASTAL FAMILY MEDICINE, INC (NPI# 1275584120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275584120 |
| Entity Type | Organization |
| Organization Name | COASTAL FAMILY MEDICINE, INC |
| Other Organization Name | FAMILY CARE CENTERS MEDICAL GROUP |
| Practice Address |
1190 W Baker St Suite 100 Costa Mesa CA 92626-4105 |
| Mailing Address |
Po Box 3699 Newport Beach CA 92659-8699 |
| Practice Telephone | 7146682500 |
| Practice Fax Number | 7146682515 |
| Mailing Telephone | 6572413600 |
| Mailing Fax Number | 6572417708 |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2020-02-21 |
| Authorized Official Name | DR. MARK D SCHAFER (PRESIDENT) |
| Authorized Official Telephone | 6572413500 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | CA | Allopathic & Osteopathic Physicians | |
| N | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
CA | Allopathic & Osteopathic Physicians | |
| N | 208D00000X | General Practice | CA | Allopathic & Osteopathic Physicians | |
| N | 363A00000X | Physician Assistant | CA | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 363L00000X | Nurse Practitioner | CA | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
CA | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE RAILROAD | DE5878 | 01 |
| Other Name | Type Code |
|---|---|
| Family Care Centers | Doing Business As Name - Organization |
| Family Care Centers Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063820181 | Coastal Family Medicine, Inc | Family Medicine | 18785 S Brookhurst St, Ste 101, Fountain Valley, CA 92708-7300 | 2014-08-01 |
| 1619232378 | Coastal Family Medicine, Inc | Family Medicine | 4950 Barranca Pkwy, Suite 103, Irvine, CA 92604-4630 | 2012-07-09 |
| 1639321953 | Coastal Family Medicine, Inc | Internal Medicine | 520 Superior Ave, Suite 205, Newport Beach, CA 92663-3637 | 2008-10-17 |
| 1265618276 | Coastal Family Medicine, Inc | Family Medicine | 26671 Aliso Creek Rd, 101, Aliso Viejo, CA 92656-4809 | 2008-01-21 |
| Street Address |
1190 W BAKER ST SUITE 100 |
| City | COSTA MESA |
| State | CA |
| Zip Code | 92626-4105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447204656 | Cathy Cumberland | General Practice | 1190 W Baker St, Ste 100, Costa Mesa, CA 92626-4105 | 2006-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536982 | Sergio Gutierrez | Behavior Technician | 3303 Harbor Blvd., Suite B8, Costa Mesa, CA 92626 | 2020-10-22 |
| 1780201848 | Kelly Chauvet | Behavior Technician | 1503 Nutmeg Place Suite 110, Costa Mesa, CA 92626 | 2020-07-06 |
| 1316564610 | Timo Rosa | Behavior Technician | 1503 Nutmeg Place, Suite 110, Costa Mesa, CA 92626 | 2020-07-02 |
| 1255966115 | Dalia A Sehweil | Behavior Technician | 1111 Baker, Costa Mesa, CA 92626 | 2020-03-11 |
| 1265071096 | Austin Stotelmyre | Behavior Technician | 1111 Baker St Costa Mesa 92626, Costa Mesa, CA 92626 | 2019-12-26 |
| 1396383022 | The Open Table | Community/Behavioral Health | 151 Kalmus Dr. Bldg C, Suite 100, Costa Mesa, CA 92626 | 2019-12-12 |
| 1851933550 | Jennifer Rivera | Behavior Technician | 1111 Baker St. Unit #a, Costa Mesa, CA 92626 | 2019-10-14 |
| 1962053595 | Peter Na | Behavior Technician | Behavior Functions 3303 Harbor Blvd, Ste B8, Costa Mesa, CA 92626 | 2019-09-25 |
| 1346897147 | Jennifer Lopez | Behavior Technician | 555 Alton Blvd Suite 150, Costa Mesa, CA 92626 | 2019-08-26 |
| 1679134084 | Danny Garcia Chiropractic, PC | Chiropractor | 1503 South Coast Drive, Suite 319, Costa Mesa, CA 92626 | 2019-06-26 |
| Find all providers in zip 92626 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104443506 | Coastal Mesa Corp. | Clinic/Center | 777 W 19th St Ste J, Costa Mesa, CA 92627-6131 | 2020-07-01 |
| 1770955593 | Susan Samueli Center | Clinic/Center | 1202 Bristol St, Suite 200, Costa Mesa, CA 92626-8605 | 2015-10-21 |
| 1588036289 | Susan Samueli Center | Clinic/Center | 1202 Bristol St, Suite 200, Costa Mesa, CA 92626-8605 | 2015-10-21 |
| 1114317872 | Susan Samueli Center | Clinic/Center | 1202 Bristol St, Suite 200, Costa Mesa, CA 92626-8605 | 2015-02-02 |
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| Find all providers with the same taxonomy | ||||
| City | COSTA MESA |
| Zip Code | 92626 |
Please comment or provide details below to improve the information on COASTAL FAMILY MEDICINE, INC.
| 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.