Organization Name: | SOUTH COAST MEDICAL CENTER FOR NEW MEDICINE, INC. |
NPI Number: | 1003284258 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LEIGH CONNEALY (OWNER) |
Mailing Address: | 6 Hughes Ste 100 Irvine |
State: | CA US |
Postal Code: | 926182060 |
Phone Number: | 9496801880 |
Fax Number: | |
NPI Enumeration Date: | 09/04/2015 |
NPI Last Update Date: | 09/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332900000X |
License Number: | G57433 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Non-Pharmacy Dispensing Site |
Taxonomy Specialization: | |
Taxonomy Definition: | A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |