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Organization
COASTAL SURGERY CENTER, INC.
Active
Organization
COASTAL SURGERY CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIM SHAD R.N. (NURSE ADMINISTRATOR)
(714) 841-4909
Entity
Organization
Contact information
Practice address
17672 BEACH BLVD, SUITE B, HUNTINGTON BEACH, CA 92647-6836
(714) 841-4909
(714) 847-8587
Mailing address
16787 BEACH BLVD, SUITE 615, HUNTINGTON BEACH, CA 92647-4848
(714) 843-9338
(714) 843-6404
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/31/2007
Last updated
10/31/2007
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