OrganizationActive
Breakwater Medical Group LLC
NPI 1497019111 · Clinical Medical Laboratory · Costa Mesa, CA
Breakwater Medical Group LLC is a Clinical Medical Laboratory organization in Costa Mesa, CA (NPI 1497019111).
Provider details
- NPI number
- 1497019111
- Entity type
- Organization
- Primary specialty
- Clinical Medical LaboratoryLaboratories
- Organization subpart
- No
- Authorized official
- Matt Luchini, Accounts Manager(928) 533-4220
- License
- 05D2040895 (CA)
Specialties & taxonomies
Laboratories
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
357 Victoria St
Suite 2
Costa Mesa, CA 92627-1931
Phone: (949) 903-1053
Fax: (877) 820-8959
Street-level locationGet directions
Mailing address
357 Victoria St
Costa Mesa, CA 92627-1931
Registry dates
- Enumerated
- 2012-06-27
- Last updated
- 2012-06-27
Frequently asked questions
- What is Breakwater Medical Group LLC's NPI number?
- Breakwater Medical Group LLC's National Provider Identifier (NPI) is 1497019111, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Breakwater Medical Group LLC?
- Breakwater Medical Group LLC is classified in the NPPES registry as Clinical Medical Laboratory (Laboratories).
- Where is Breakwater Medical Group LLC located?
- Breakwater Medical Group LLC's practice location on file with NPPES is 357 Victoria St, Costa Mesa, CA 92627-1931.
- What is Breakwater Medical Group LLC's phone number?
- The practice phone number listed in the NPPES registry for Breakwater Medical Group LLC is (949) 903-1053.
- Who is the authorized official for Breakwater Medical Group LLC?
- The authorized official listed on Breakwater Medical Group LLC's NPPES record is Matt Luchini, Accounts Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Breakwater Medical Group LLC's NPI active?
- Yes — Breakwater Medical Group LLC's NPI (1497019111) is active in the NPPES registry as of the last update on 2012-06-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.