Organization
PACIFICOAST AMBULATORY SURGICENTER, LLC.
Active
Other names
Pacific Coast Ambulatory Surgicenter
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS GANGNES (GENERAL MANAGER)
(949) 276-4141
Entity
Organization
Contact information
Practice address
665 CAMINO DE LOS MARES, SUITE 100C, SAN CLEMENTE, CA 92673-2859
(949) 481-7760
Mailing address
665 CAMINO DE LOS MARES, SUITE 100C, SAN CLEMENTE, CA 92673-2859
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
18448
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18448
STATE LIC. #
CA
Enumeration date
07/10/2006
Last updated
12/15/2015
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