Organization
SOUTH COAST EYE CARE CENTERS A COMP OPHTHALMOLOGY MEDICAL GRP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW HENRICK M.D. (PRESIDENT)
(949) 588-2020
Entity
Organization
Contact information
Practice address
23961 CALLE DE LA MAGDALENA, STE. 302, LAGUNA HILLS, CA 92653-3616
(949) 588-2020
(949) 588-0336
Mailing address
23961 CALLE DE LA MAGDALENA, STE. 302, LAGUNA HILLS, CA 92653-3616
(949) 588-2020
(949) 588-0336
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
A77935
CA
207W00000X
Ophthalmology Physician
Primary
G36573
CA
207W00000X
Ophthalmology Physician
G73434
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0102520
—
CA
Enumeration date
06/01/2006
Last updated
03/15/2010
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