Healthcare Provider Details

I. General information

NPI: 1356488738
Provider Name (Legal Business Name): SOUTH COAST UROGYNECOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 02/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31852 COAST HWY SUITE 200
LAGUNA BEACH CA
92651-6764
US

IV. Provider business mailing address

31852 COAST HWY SUITE 200
LAGUNA BEACH CA
92651-6764
US

V. Phone/Fax

Practice location:
  • Phone: 949-499-5311
  • Fax: 949-499-5312
Mailing address:
  • Phone: 949-499-5311
  • Fax: 949-499-5312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RED M ALINSOD
Title or Position: OWNER
Credential: MD
Phone: 949-499-5311