BREAKWATER MEDICAL GROUP LLC
NPI 1497019111
Clinical Medical Laboratory in Costa Mesa, CA

Active since June 27, 2012
357 VICTORIA ST, SUITE 2, COSTA MESA, CA 92627(949) 903-1053(877) 820-8959 Get Directions Write a Review

NPPES record last updated: June 27, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Breakwater Medical Group Llc NPPES

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

BREAKWATER MEDICAL GROUP LLC (NPI 1497019111) is a healthcare organization registered as a clinical medical laboratory in Costa Mesa, California and active in the NPI registry since June 2012. The organization lists Matt Luchini, Accounts Manager, as its authorized official.

NPPES Registry Identity

NPI1497019111
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameBREAKWATER MEDICAL GROUP LLC
Location Address357 VICTORIA ST, SUITE 2Costa Mesa, CA 92627-1931
Mailing Address357 Victoria St, Suite 2Costa Mesa, CA 92627-1931 · (949) 903-1053 · Fax (877) 820-8959
Fax(877) 820-8959
Organization SubpartNo
Authorized OfficialMatt LuchiniAccounts Manager · (928) 533-4220
Enumeration DateJune 27, 2012
NPI 1497019111 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
License Licensed in CA · 05D2040895
Definition
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
357 VICTORIA ST, 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 Breakwater Medical Group LLC's NPI number?

The NPI number for Breakwater Medical Group LLC is 1497019111. It was assigned to this organization in the NPPES registry on June 27, 2012.

Where is Breakwater Medical Group LLC located?

Breakwater Medical Group LLC is located at 357 Victoria St Suite 2, Costa Mesa, CA 92627. The listed phone number is (949) 903-1053.

What is Breakwater Medical Group LLC's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

When was this NPI record last updated?

The NPPES record for Breakwater Medical Group LLC was last updated on June 27, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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.