Healthcare Provider Details

I. General information

NPI: 1821232851
Provider Name (Legal Business Name): NORTH COAST SURGICAL MEDICAL SERVICE ORGANIZATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2009
Last Update Date: 04/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 SANTA FE DRIVE STE 1
ENCINITAS CA
92024-5137
US

IV. Provider business mailing address

351 SANTA FE DR STE 1
ENCINITAS CA
92024-5137
US

V. Phone/Fax

Practice location:
  • Phone: 760-753-1050
  • Fax: 760-753-2506
Mailing address:
  • Phone: 760-753-1050
  • Fax: 760-753-2506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES CHAO
Title or Position: MEMBER
Credential: M.D.
Phone: 760-753-1050