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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