=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356488738
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOUTH COAST UROGYNECOLOGY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/01/2007
-----------------------------------------------------
Last Update Date | 02/19/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 31852 COAST HWY SUITE 200
-----------------------------------------------------
City | LAGUNA BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92651-6764
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-499-5311
-----------------------------------------------------
Fax | 949-499-5312
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 31852 COAST HWY SUITE 200
-----------------------------------------------------
City | LAGUNA BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92651-6764
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-499-5311
-----------------------------------------------------
Fax | 949-499-5312
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. RED M ALINSOD
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 949-499-5311
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208800000X
-----------------------------------------------------
Taxonomy Name | Urology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207VG0400X
-----------------------------------------------------
Taxonomy Name | Gynecology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------