Mr Kelly Gene Coburn, LMFT in Santa Ana, CA - Medicare Marriage & Family Therapist Provider

Mr Kelly Gene Coburn, LMFT is a medicare enrolled "Marriage & Family Therapist" provider in Santa Ana, California. His current practice location is 401 W Civic Center Dr Ste 600, Santa Ana, California. You can reach out to his office (for appointments etc.) via phone at (714) 850-8405.

Mr Kelly Gene Coburn is licensed to practice in California (license number 112266) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1750633970.

Contact Information

	Mr Kelly Gene Coburn, LMFT
	401 W Civic Center Dr Ste 600, Santa Ana, CA 92701-4515
	(714) 850-8405
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Kelly Gene Coburn
Gender	Male
Speciality	Marriage & Family Therapist
Location	401 W Civic Center Dr Ste 600, Santa Ana, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1750633970
Provider Enumeration Date: 10/11/2012
Last Update Date: 05/26/2021

Medicare PECOS Information:

PECOS PAC ID: 5890217301
Enrollment ID: I20250313002004

Medical Identifiers

Medical identifiers for Mr Kelly Gene Coburn such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1750633970	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
106H00000X	Marriage & Family Therapist	112266 (California)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Kelly Gene Coburn allows following entities to bill medicare on his behalf.

Entity Name	County Of Orange
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1104963347 PECOS PAC ID: 1951215789 Enrollment ID: O20031117000447

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Kelly Gene Coburn is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Kelly Gene Coburn, LMFT 2035 E Ball Rd, Ste. 100-a, Anaheim, CA 92806-5159 Ph: (714) 517-6152	Mr Kelly Gene Coburn, LMFT 401 W Civic Center Dr Ste 600, Santa Ana, CA 92701-4515 Ph: (714) 850-8405

Reviews and Comments

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Mr Kelly Gene Coburn, LMFT - Medicare Couples Therapy in Santa Ana, CA