Organization
SOUTH COAST MEDICAL CENTER FOR NEW MED.INC
Active
Parent organization
SOUTH COAST MEDICAL CENTER FOR NEW MED. INC.
Other names
S C Medical Imaging
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTH COAST MEDICAL CENTER FOR NEW MED. INC.
Authorized official
DR. LEIGH ERIN CONNEALY M. D. (MEDICAL DIRECTOR/OWNER)
(949) 680-1907
Entity
Organization
Contact information
Practice address
6 HUGHES, SUITE 100-150, IRVINE, CA 92618-2059
(949) 680-1907
Mailing address
55 VERNAL SPG, IRVINE, CA 92603-0404
(949) 680-1907
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
2471C3401X
Computed Tomography Radiologic Technologist
Primary
BUS06-02166
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BUS06-02166
CITY OF IRVINE BUSINESS L
—
01
—
G57433
STATE MEDICAL LICENSE
CA
Enumeration date
07/13/2007
Last updated
03/07/2023
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