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General NPI Number Information
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NPI Number | 1942116959
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Entity Type | Organization
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Legal Business Name | SOUTH COAST ADVANCED IMAGING INC
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Dates
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Enumeration Date | 08/20/2026
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Last Update Date | 08/20/2026
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Provider Practice Location Address
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Address Line | 27882 FORBES RD STE 1220
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-1267
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Country | US
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Telephone | 949-484-8898
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Fax | 949-222-9969
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Provider Business Mailing Address
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Address Line | 27882 FORBES RD STE 1220
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-1267
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Country | US
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Telephone | 949-484-8898
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Fax | 949-222-9969
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | OMID VESAL
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Credential | MD
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Telephone | 949-484-8898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology 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 | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number |
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License Number State |
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