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General NPI Number Information
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NPI Number | 1386214732
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Entity Type | Organization
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Legal Business Name | ORANGE COAST CARDIOLOGY MEDICAL CORPORATION
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Dates
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Enumeration Date | 06/29/2021
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Last Update Date | 01/19/2025
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Provider Practice Location Address
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Address Line | 520 SUPERIOR AVE STE 220
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3671
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Country | US
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Telephone | 949-515-4515
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Fax | 949-515-4508
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Provider Business Mailing Address
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Address Line | 28241 CROWN VALLEY PKWY # F337
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-4441
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Country | US
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Telephone | 949-515-4515
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RADHAKRISHAN S GANDHI
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Credential | MD
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Telephone | 949-515-4515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology 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 | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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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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