MEDICARE: PACIFIC COAST HYDRATION INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	2084P0800X	Psychiatry Physician
3	207LP2900X	Pain Medicine (Anesthesiology) Physician
4	2084P2900X	Pain Medicine (Psychiatry & Neurology) Physician
5	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1720689540
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACIFIC COAST HYDRATION INC

Provider Business Mailing Address
First Line	:	110 BELLATRIX
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92618-1727
Country	:	US
Telephone Number	:	404-668-2292
Fax Number	:

Provider Business Practice Location Address
First Line	:	20951 BROOKHURST ST STE 107
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92646-6648
Country	:	US
Telephone Number	:	949-469-0675
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALGENON M PARSON
Credential	:	MD
Telephone Number	:	949-572-7375

Provider Enumeration Date	:	11/06/2020
Last Update Date	:	03/05/2026

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