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General NPI Number Information
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NPI Number | 1205984960
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Entity Type | Organization
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Legal Business Name | SOUTH COAST EAR NOSE & THROAT A MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 07/05/2018
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Provider Practice Location Address
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Address Line | 800 CORPORATE DR SUITE 290
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City | LADERA RANCH
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State | CA
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Zip | 92694
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Country | US
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Telephone | 949-218-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 800 CORPORATE DR SUITE 290
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City | LADERA RANCH
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State | CA
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Zip | 92694-1152
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AVRUM AARON KAUFMAN
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Credential | DO
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Telephone | 949-218-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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