Coastal Surgery Center, Inc.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

COASTAL SURGERY CENTER, INC.

Practice address

17672 Beach Blvd
Suite B
Huntington Beach, CA 92647-6836

Phone

(714) 841-4909

Fax

(714) 847-8587

NPI assigned

Oct 31, 2007

Organization subpart

No

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

Authorized official

Name

Jim Shad, R.N.

Title

Nurse Administrator

Phone

(714) 841-4909

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1083893572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16787 BEACH BLVD",
            "address_2": "SUITE 615",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926474848",
            "telephone_number": "714-843-9338",
            "fax_number": "714-843-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17672 BEACH BLVD",
            "address_2": "SUITE B",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926476836",
            "telephone_number": "714-841-4909",
            "fax_number": "714-847-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL SURGERY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "SHAD",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "NURSE ADMINISTRATOR",
        "authorized_official_telephone_number": "714-841-4909",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coast Multi Specialty Surgery Center Inc.
• Coast Surgery Center
• Coast Surgery Center Inc.
• Coastal Cities Transportation
• Coastal Primary Care
• Coastline Anesthesia & Pain Management Group a Medical Corpora
• Coastline Dental Care
• Coastline Recovery for Women LLC
• Coastline Recovery LLC
• Coastline Therapies

• Ambulatory Surgical Clinic/Center in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.