# SOUTH COAST EYE CARE CENTERS A COMP OPHTHALMOLOGY MEDICAL GRP INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063459725
- **Authorized official:** DR. ANDREW HENRICK M.D. (PRESIDENT)
- **Authorized official phone:** (949) 588-2020

## Contact information

- **Practice address:** 23961 CALLE DE LA MAGDALENA, STE. 302, LAGUNA HILLS, CA 92653-3616
- **Practice address phone:** (949) 588-2020
- **Practice address fax:** (949) 588-0336
- **Mailing address:** 23961 CALLE DE LA MAGDALENA, STE. 302, LAGUNA HILLS, CA 92653-3616
- **Mailing address phone:** (949) 588-2020
- **Mailing address fax:** (949) 588-0336

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | A77935 | CA | — |
| 207W00000X | Ophthalmology Physician | G36573 | CA | Yes |
| 207W00000X | Ophthalmology Physician | G73434 | CA | — |

## Other

- **Enumeration date:** 06/01/2006
- **Last updated:** 03/15/2010