South Coast Medical Group Family And Sports Medicine - Medicare Primary Care in Aliso Viejo, CA

South Coast Medical Group Family And Sports Medicine is a medicare enrolled primary clinic (Clinic/center - Primary Care) in Aliso Viejo, California. The current practice location for South Coast Medical Group Family And Sports Medicine is 5 Journey Ste 130, Aliso Viejo, California. For appointments, you can reach them via phone at (949) 360-1069. The mailing address for South Coast Medical Group Family And Sports Medicine is 5 Journey Ste 130, Aliso Viejo, California and phone number is (949) 360-1069.

South Coast Medical Group Family And Sports Medicine is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1649337221. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (949) 360-1069.

Contact Information

South Coast Medical Group Family And Sports Medicine
5 Journey Ste 130
Aliso Viejo
CA 92656-5330
(949) 360-1069
(949) 389-8968

Primary Care Clinic Profile

Full NameSouth Coast Medical Group Family And Sports Medicine
SpecialityClinic/Center
Location5 Journey Ste 130, Aliso Viejo, California
Authorized Official Name and PositionJohnna Gherardini (EXECUTIVE DIRECTOR)
Authorized Official Contact9493601069
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
South Coast Medical Group Family And Sports Medicine
5 Journey Ste 130
Aliso Viejo
CA 92656-5330

Ph: (949) 360-1069
South Coast Medical Group Family And Sports Medicine
5 Journey Ste 130
Aliso Viejo
CA 92656-5330

Ph: (949) 360-1069

NPI Details:

NPI Number1649337221
Provider Enumeration Date01/02/2007
Last Update Date07/30/2015

Medicare PECOS Information:

Medicare PECOS PAC ID5991793531
Medicare Enrollment IDO20040503001735

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Medical Identifiers

Medical identifiers for South Coast Medical Group Family And Sports Medicine such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1649337221NPI-NPPES
1619061397OtherCAJOHN CHENG, MD
1598723058OtherCAARCHANNA BHOGILL, MD
1861586554OtherCASHANNON O'CONNOR, MD
1932284478OtherCAERIC CLARK, MD

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QP2300XClinic/center - Primary Care (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. South Coast Medical Group Family And Sports Medicine acts as a billing entity for following providers:
Provider NameShannon O Connor
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1861586554
PECOS PAC ID: 6901090455
Enrollment ID: I20101029000057

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South Coast Medical Group
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 5 Journey, Suite 130, Aliso Viejo, CA 92656
Phone: 949-360-1069    Fax: 949-389-8969
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