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General NPI Number Information
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NPI Number | 1720689540
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Entity Type | Organization
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Legal Business Name | PACIFIC COAST HYDRATION INC
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Dates
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Enumeration Date | 11/06/2020
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 20951 BROOKHURST ST STE 107
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-6648
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Country | US
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Telephone | 949-469-0675
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Fax |
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Provider Business Mailing Address
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Address Line | 110 BELLATRIX
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City | IRVINE
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State | CA
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Zip | 92618-1727
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Country | US
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Telephone | 404-668-2292
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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. ALGENON M PARSON
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Credential | MD
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Telephone | 949-572-7375
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine 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 | 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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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P2900X
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Taxonomy Name | Pain Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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