BROAD MEDICAL GROUP INC.
NPI 1255997763
Obstetrics & Gynecology in Costa Mesa, CA

Active since May 10, 2019
1640 NEWPORT BLVD STE 300, COSTA MESA, CA 92627(949) 720-9848(949) 720-9195 Get Directions Write a Review

NPPES record last updated: September 6, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 6, 2025, May 10, 2019 (2 updates tracked since 2019).

About Broad Medical Group Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROAD MEDICAL GROUP INC. (NPI 1255997763) is a healthcare organization registered as an obstetrics & gynecology in Costa Mesa, California and active in the NPI registry since May 2019. The organization lists Jennifer Lauren Broad, Ceo/president, as its authorized official.

NPPES Registry Identity

NPI1255997763
Entity TypeOrganization
Primary Taxonomy207V00000X
Legal Business NameBROAD MEDICAL GROUP INC.
Location Address1640 NEWPORT BLVD STE 300Costa Mesa, CA 92627-7725
Mailing Address1640 Newport Blvd Ste 300Costa Mesa, CA 92627-7725 · (929) 720-9848 · Fax (949) 720-9195
Fax(949) 720-9195
Organization SubpartNo
Authorized OfficialJennifer Lauren BroadCeo/president · (949) 720-9848
Enumeration DateMay 10, 2019
Last NPPES UpdateSeptember 6, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 6, 2025
NPI 1255997763 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
1640 NEWPORT BLVD STE 300, Costa Mesa, CA 92627

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
1640 NEWPORT BLVD STE 300
COSTA MESA, CA 92627
Internal Medicine
1640 NEWPORT BLVD STE 300
COSTA MESA, CA 92627
Internal Medicine
1640 NEWPORT BLVD STE 300
COSTA MESA, CA 92627
Family Medicine
1640 NEWPORT BLVD STE 300
COSTA MESA, CA 92627
Obstetrics & Gynecology
1640 NEWPORT BLVD STE 300
COSTA MESA, CA 92627

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Broad Medical Group Inc.'s NPI number?

The NPI number for Broad Medical Group Inc. is 1255997763. It was assigned to this organization in the NPPES registry on May 10, 2019.

Where is Broad Medical Group Inc. located?

Broad Medical Group Inc. is located at 1640 Newport Blvd Ste 300, Costa Mesa, CA 92627. The listed phone number is (949) 720-9848.

What is Broad Medical Group Inc.'s specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

When was this NPI record last updated?

The NPPES record for Broad Medical Group Inc. was last updated on September 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.