Provider Demographics
NPI:1124314281
Name:SURGERY CENTER AT SOUTH COAST PLAZA
Entity type:Organization
Organization Name:SURGERY CENTER AT SOUTH COAST PLAZA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HOANG
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-619-2650
Mailing Address - Street 1:3420 BRISTOL ST
Mailing Address - Street 2:SUITE 701
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-7170
Mailing Address - Country:US
Mailing Address - Phone:714-619-2658
Mailing Address - Fax:855-885-2620
Practice Address - Street 1:3420 BRISTOL ST
Practice Address - Street 2:SUITE 701
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-7170
Practice Address - Country:US
Practice Address - Phone:714-619-2658
Practice Address - Fax:855-885-2620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical