Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Oac Southern Medical Professional Corporation

Organization Sports Medicine (Physical Medicine & Rehabilitation) Physician · NPI 1164777090

Oac Southern Medical Professional Corporation is a Sports Medicine (Physical Medicine & Rehabilitation) Physician in Newport Beach, California. Licensed in California. Registered with an NPI since 2012.

Licensed in
CA
In the registry since
2012

Practice location Address checks out

3300 W Coast Hwy Ste A
Newport Beach, CA 92663-4007
Phone: (949) 209-0220
Fax: (949) 270-5139
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Physical Medicine & Rehabilitation) Physician (primary) Taxonomy 2081S0010X · Licence 20A10143 (CA)

Record details

NPI number1164777090
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Maryam Rahimi — President · (310) 634-1146
NPI enumeratedJuly 17, 2012
Last updated in NPPESJuly 17, 2012
Mailing address23430 Hawthorne Blvd, Suite 125, Torrance, CA 90505-4720

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