Organization
SOUTH COAST FAMILY MEDICAL CENTER INC
Active
Organization
SOUTH COAST FAMILY MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL ALAN KENT M.D., (OWNER)
(949) 643-8921
Entity
Organization
Contact information
Practice address
25500 RANCHO NIGUEL RD STE 100, LAGUNA NIGUEL, CA 92677-7373
(949) 643-8921
(949) 643-3914
Mailing address
25500 RANCHO NIGUEL RD STE 100, LAGUNA NIGUEL, CA 92677-7373
(949) 643-8921
(949) 643-3914
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A37009
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1952335598
NPI MICHAEL KENT MD
CA
01
—
A37009
BLUE CROSS LICENSE
CA
01
—
ZZZ26875Z
BLUE SHIELD
CA
Enumeration date
06/27/2007
Last updated
05/27/2008
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