Organization
SURGICAL GROUP OF SOUTH LAGUNA A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN T CHANG MD (PRESIDENT)
(949) 499-4565
Entity
Organization
Contact information
Practice address
31862 SO COAST HWY, #201, LAGUNA BEACH, CA 92651
(949) 499-4565
(949) 499-5265
Mailing address
31862 SO COAST HWY, #201, LAGUNA BEACH, CA 92651
(949) 499-4565
(949) 499-5265
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G059754
CA
208600000X
Surgery Physician
G084402
CA
2086S0129X
Vascular Surgery Physician
G059754
CA
2086S0129X
Vascular Surgery Physician
G084402
CA
Other
Enumeration date
09/20/2006
Last updated
12/06/2010
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