# WEST COAST UROLOGY

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

## Provider details

- **NPI number:** 1417432527
- **Authorized official:** WILSON ROVIRA PENA (PRESIDENT)
- **Authorized official phone:** (787) 832-2395

## Contact information

- **Practice address:** HOSPITAL LA CONCEPCION, TORRE MEDICA SAN VICENTE DE PAUL OFICINA 609-610, SAN GERMAN, PR 00683
- **Practice address phone:** (787) 659-7444
- **Mailing address:** PO BOX 601, MAYAGUEZ, PR 00681-0601

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/25/2018
- **Last updated:** 09/25/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1568758332 | NPPES | — |