Coronado Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CORONADO SURGERY CENTER LLC

Practice address

4501 Birch Street
Newport Beach, CA 92660-8602

Phone

(661) 472-4177

Fax

(760) 262-3917

NPI assigned

Feb 7, 2015

Organization subpart

No

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

Authorized official

Name

Elena Serda

Title

Owner

Phone

(661) 472-4177

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1423267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435622400000",
    "number": "1124419510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 BIRCH STREET",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926608602",
            "telephone_number": "661-472-4177",
            "fax_number": "760-262-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 BIRCH STREET",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926608602",
            "telephone_number": "661-472-4177",
            "fax_number": "760-262-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORONADO SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-07",
        "last_updated": "2015-06-30",
        "status": "A",
        "authorized_official_last_name": "SERDA",
        "authorized_official_first_name": "ELENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-472-4177"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Cornejo, PT, MPT, CFMT
• Melanie Ann Cornejo, P.T.
• William J Cornejo
• Jacob Andrew Cornett, MD
• Crystal Marie Corona
• Alissa Coronado
• Sulema Coronado
• Lexy Coronel
• Liliana Coronel
• Corpodian Dental Corporation

• Ambulatory Surgical Clinic/Center in Newport Beach, CA
• Providers in Newport 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 Jun 30, 2015; 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.