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General NPI Number Information
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NPI Number | 1053029918
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Entity Type | Organization
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Legal Business Name | EVAGELOS COSKINAS MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 11/09/2022
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 301 VICTORIA ST
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City | COSTA MESA
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State | CA
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Zip | 92627-1995
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Country | US
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Telephone | 949-500-5108
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Fax | 951-244-0747
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Provider Business Mailing Address
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Address Line | 31103 RANCHO VIEJO RD STE D3319
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-1759
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Country | US
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Telephone | 951-244-4147
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Fax | 951-244-0747
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Authorized Official
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Title or Position | OWNER/PSYCHIATRIST
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Name | DR. EVAGELOS COSKINAS
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Credential | MD
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Telephone | 949-500-5108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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