Organization
COAST RADIOLOGY IMAGING AND INTERVENTION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD LEMPERT M.D. (PRESIDENT)
(949) 364-7744
Entity
Organization
Contact information
Practice address
27700 MEDICAL CENTER ROAD, RADIOLOGY DEPARTMENT, MISSION VIEJO, CA 92691
(949) 364-7744
(949) 364-4233
Mailing address
DEPT LA 21789, PASADENA, CA 91185-1789
(949) 263-8620
(949) 263-1639
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0104330
—
CA
01
—
ZZZ69492Z
BLUE SHIELD
CA
01
—
ZZZ69493Z
BLUE SHIELD
CA
01
—
ZZZ69494Z
BLUE SHIELD
CA
Enumeration date
01/05/2007
Last updated
11/30/2007
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