Organization
WEST COAST PETCT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS A. POAN (SVP - CORPORATE FINANCE)
(949) 242-5321
Entity
Organization
Contact information
Practice address
27882 FORBES RD, SUITE 120, LAGUNA NIGUEL, CA 92677-1267
(866) 533-4296
Mailing address
100 BAYVIEW CIR, SUITE 400, NEWPORT BEACH, CA 92660-2983
(949) 242-5384
(480) 212-8589
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
CA
Other
Enumeration date
03/17/2009
Last updated
03/17/2009
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