Coastal Image Group

Primary specialty

Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X

License

A86825 Issued in CA

Legal business name

COASTAL IMAGE GROUP

Practice address

62 Corporate Park Ste 120
Irvine, CA 92606-3142

Phone

(949) 701-3394

Fax

(949) 748-8868

NPI assigned

Jan 3, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ellen Teresa Song, M.D.

Title

President

Phone

(714) 904-5594

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1230940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230940800000",
    "number": "1073759601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 CORPORATE PARK STE 120",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926063142",
            "telephone_number": "949-701-3394",
            "fax_number": "949-748-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 CORPORATE PARK STE 120",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926063142",
            "telephone_number": "949-701-3394",
            "fax_number": "949-748-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL IMAGE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-03",
        "last_updated": "2009-01-03",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "TERESA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-904-5594",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A86825",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "CA",
            "license": "A86825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Aryel Genae Coats
• Caleigh Cobb

• Diagnostic Ultrasound Physician in Irvine, CA
• Providers in Irvine, CA by specialty
• Diagnostic Ultrasound Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.