Healthcare Provider Details

I. General information

NPI: 1942116959
Provider Name (Legal Business Name): SOUTH COAST ADVANCED IMAGING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27882 FORBES RD STE 1220
LAGUNA NIGUEL CA
92677-1267
US

IV. Provider business mailing address

27882 FORBES RD STE 1220
LAGUNA NIGUEL CA
92677-1267
US

V. Phone/Fax

Practice location:
  • Phone: 949-484-8898
  • Fax: 949-222-9969
Mailing address:
  • Phone: 949-484-8898
  • Fax: 949-222-9969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: OMID VESAL
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 949-484-8898