Healthcare Provider Details

I. General information

NPI: 1972622371
Provider Name (Legal Business Name): SOUTH COAST GLOBAL MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 S BRISTOL ST
SANTA ANA CA
92704-6201
US

IV. Provider business mailing address

1301 N TUSTIN AVE
SANTA ANA CA
92705-8619
US

V. Phone/Fax

Practice location:
  • Phone: 714-754-5454
  • Fax:
Mailing address:
  • Phone: 714-953-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number060000143
License Number StateCA

VIII. Authorized Official

Name: MR. WILLIAM THOMAS
Title or Position: OFFICER
Credential:
Phone: 951-782-8812