Healthcare Provider Details

I. General information

NPI: 1235195033
Provider Name (Legal Business Name): NORTH COAST SURGERY CENTER LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 09/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3903 WARING RD
OCEANSIDE CA
92056-4405
US

IV. Provider business mailing address

3903 WARING RD
OCEANSIDE CA
92056-4405
US

V. Phone/Fax

Practice location:
  • Phone: 760-940-0997
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: MRS. SHARON E. GRAY
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 760-940-0997