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SOUTH COAST PEDIATRICS
NPI 1891860748
Pediatrics - Adolescent Medicine in Anaheim, CA

Active since November 22, 2006CLIA 05D1008631 · Waiver
1720 W BALL RD, STE.#1, ANAHEIM, CA 92804(714) 991-5141(714) 991-5144 Get Directions Write a Review

NPPES record last updated: December 8, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About South Coast Pediatrics NPPES

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

SOUTH COAST PEDIATRICS (NPI 1891860748) is a healthcare organization registered as an adolescent medicine in Anaheim, California and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through January 23, 2027 and lists Jacob Wolsztejn, President, as its authorized official.

NPPES Registry Identity

NPI1891860748
Entity TypeOrganization
Primary Taxonomy2080A0000X
Legal Business NameSOUTH COAST PEDIATRICS
Location Address1720 W BALL RD, STE.#1Anaheim, CA 92804-5500
Mailing Address1720 W Ball Rd, Ste.#1Anaheim, CA 92804-5500 · (714) 991-5141
Phone(714) 991-5141
Fax(714) 991-5144
Organization SubpartNo
Authorized OfficialJacob WolsztejnPresident · (714) 991-5141
Enumeration DateNovember 22, 2006
Last NPPES UpdateDecember 8, 2011
✔ NPI 1891860748 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
1720 W BALL RD, Anaheim, CA 92804
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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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D1008631

South Coast Pediatrics · Anaheim, CA
Active · expires Jan 23, 2027
CLIA Number05D1008631
Laboratory TypePhysician Office
Certificate Effective DateJanuary 24, 2025
Certificate Expiration DateJanuary 23, 2027
Laboratory DirectorJacob Wolsztejn
Laboratory Phone(714) 991-5141
Laboratory LocationSouth Coast Pediatrics1720 W Ball Rd Ste 1, Anaheim, CA 92804
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

DR. MICHIE MORENO M.D.
General Practice
1720 W BALL RD, SUITE 3C
ANAHEIM, CA 92804
Orange County (714) 533-7005
SARAH NAMUKONO KIRYA PA
Physician Assistant (Medical)
1720 W BALL RD, 4B
ANAHEIM, CA 92804
Orange County (174) 254-0224
GISSELLE PRADO
Behavior Analyst
1720 W BALL RD
ANAHEIM, CA 92804
Orange County (661) 932-6448

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 South Coast Pediatrics's NPI number?

The NPI number for South Coast Pediatrics is 1891860748. It was assigned to this organization in the NPPES registry on November 22, 2006.

Where is South Coast Pediatrics located?

South Coast Pediatrics is located at 1720 W Ball Rd Ste.#1, Anaheim, CA 92804. The listed phone number is (714) 991-5141.

What is South Coast Pediatrics's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Does South Coast Pediatrics hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1008631) is associated with this NPI, valid through January 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for South Coast Pediatrics was last updated on December 8, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.