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General NPI Number Information
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NPI Number | 1356089551
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Entity Type | Organization
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Legal Business Name | WEST COAST CARDIOVASCULAR PC
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Dates
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Enumeration Date | 05/26/2022
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 1640 NEWPORT BLVD STE 445
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City | COSTA MESA
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State | CA
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Zip | 92627-7730
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Country | US
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Telephone | 714-241-9070
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Fax |
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Provider Business Mailing Address
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Address Line | 1640 NEWPORT BLVD STE 445
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City | COSTA MESA
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State | CA
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Zip | 92627-7730
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Country | US
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Telephone | 714-241-9070
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Fax | 949-695-2693
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SOORAJ MALAY SHAH
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Credential | MD
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Telephone | 714-241-9070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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