Provider Demographics
NPI:1194079186
Name:COAST SURGICAL CONSULTANTS
Entity type:Organization
Organization Name:COAST SURGICAL CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHEIMANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-847-3322
Mailing Address - Street 1:8700 WARNER AVE
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-3207
Mailing Address - Country:US
Mailing Address - Phone:714-847-3322
Mailing Address - Fax:714-847-3993
Practice Address - Street 1:8700 WARNER AVE
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-3207
Practice Address - Country:US
Practice Address - Phone:714-847-3322
Practice Address - Fax:714-847-3993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory