Organization
PACIFIC COAST HEART CENTER A PROFESSIONAL MEDICAL CORP
Active
Organization
PACIFIC COAST HEART CENTER A PROFESSIONAL MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE M. THEARD MD (PRESIDENT)
(949) 495-0800
Entity
Organization
Contact information
Practice address
30131 TOWN CENTER DR, SUITE 237, LAGUNA NIGUEL, CA 92677
(949) 495-0800
(949) 495-0805
Mailing address
30131 TOWN CENTER DR, SUITE 237, LAGUNA NIGUEL, CA 92677
(949) 495-0800
(949) 495-0805
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WC50353A
MEDICARE INDIVIDUAL PTAN
CA
Enumeration date
04/18/2007
Last updated
11/22/2013
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