South Coast Outpatient Surgery Center
LBN: South Coast Outpatient Surg Ctr Balboa Surgery Center
South Coast Outpatient Surgery Center is an health care organization with primary practice located at 1101 Bayside Dr Suite 101, Corona Del Mar CA 92625-1702. The organization recently has only one registered license in Ambulatory Health Care Facilities / Ambulatory Surgical, which is considered as the primary health care specialty.
South Coast Outpatient Surg Ctr Balboa Surgery Center can be contacted via phone (949) 718-6900, or through Niccole, Michael Wayne via phone (310) 792-3914.
Contact Information
Primary practice address
1101 Bayside Dr Suite 101
Corona Del Mar CA 92625-1702
Phone: (949) 718-6900
Fax: (949) 718-9367
Website:
Authorized official contact:
Name: Niccole, Michael Wayne Doctor of Medicine (MD)
Phone: (310) 792-3914
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Ambulatory Surgical | 261QA1903X | California |
Profile Details
| NPI number | 1053545905 |
|---|---|
| LBN Legal business name | South Coast Outpatient Surg Ctr Balboa Surgery Center |
| DBA Doing business as | South Coast Outpatient Surgery Center |
| Authorized official | Niccole, Michael Wayne Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 6th, 2009 |
| Last updated | Oct 30th, 2018 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053545905 | NPPES |
| California | Other | F1929 | PTAN |
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