Organization
SOUTH COAST MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNNA GHERARDINI BSBA (EXECUTIVE DIRECTOR)
(949) 360-1069
Entity
Organization
Contact information
Practice address
5 JOURNEY SUITE 130, ALISO VIEJO, CA 92656
(949) 360-1069
Mailing address
5 JOURNEY SUITE 130, ALISO VIEJO, CA 92656
(949) 360-1069
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
10/02/2006
Last updated
08/22/2020
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