Healthcare Provider Details

I. General information

NPI: 1295918977
Provider Name (Legal Business Name): WEST COAST CENTERS FOR SURGERIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2007
Last Update Date: 08/28/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

653 CAMINO DE LOS MARES SUITE 101
SAN CLEMENTE CA
92673-2808
US

IV. Provider business mailing address

653 CAMINO DE LOS MARES SUITE 107
SAN CLEMENTE CA
92673-2808
US

V. Phone/Fax

Practice location:
  • Phone: 949-489-2218
  • Fax: 949-496-3604
Mailing address:
  • Phone: 949-489-2218
  • Fax: 949-496-3604

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. RAMIN TAYANI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 949-489-2218