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Organization
WEST COAST RADIOLOGY CENTER SOUTH COAST
Active
Organization
WEST COAST RADIOLOGY CENTER SOUTH COAST
Active
Parent organization
WEST COAST RADIOLOGY, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEST COAST RADIOLOGY, INC.
Authorized official
DR. MICHAEL L. BLACK M.D. (MEDICAL DIRECTOR)
(714) 835-6055
Entity
Organization
Contact information
Practice address
2620 S BRISTOL ST, SANTA ANA, CA 92704-5727
(714) 966-0904
(714) 966-0972
Mailing address
PO BOX 11924, SANTA ANA, CA 92711-1924
(714) 835-3709
(714) 836-7034
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Enumeration date
02/19/2009
Last updated
06/08/2009
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