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Organization

WEST COAST MEDCORP INC

Active
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Organization

WEST COAST MEDCORP INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KEVIN DRAKE M.D. (MEDICAL DIRECTOR)
(818) 986-8800
Entity
Organization

Contact information

Practice address
15720 VENTURA BLVD, STE. 417, ENCINO, CA 91436-2914
(800) 967-3309
Mailing address
15720 VENTURA BLVD., STE. 417, ENCINO, CA 91436-2911
(800) 967-3309

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2085R0204X
Vascular & Interventional Radiology Physician
2085U0001X
Diagnostic Ultrasound Physician
208D00000X
General Practice Physician

Other

Enumeration date
07/02/2014
Last updated
07/22/2014
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