NPIMap

Organization Active NPI

West Coast Radiology Center South Coast

  • Diagnostic Radiology Physician
  • Santa Ana, CA
National Provider Identifier
1740429422
Registry record updated Jun 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
WEST COAST RADIOLOGY CENTER SOUTH COAST
Practice address
2620 S Bristol St
Santa Ana, CA 92704-5727
Phone
(714) 966-0904
Fax
(714) 966-0972
NPI assigned
Feb 19, 2009
Organization subpart
Yes
Parent organization
WEST COAST RADIOLOGY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 8, 2009

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

Authorized official

Name
Dr. Michael L. Black, M.D.
Title
Medical Director
Phone
(714) 835-6055

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085B0100X
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X Primary
Diagnostic Ultrasound PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085U0001X

Addresses

Primary practice location

2620 S Bristol St
Santa Ana, CA 92704-5727

Mailing address

PO Box 11924
Santa Ana, CA 92711-1924
Phone (714) 835-3709

National Provider Directory

National Provider Directory
Tax ID family
West Coast Breast Center-Santa Ana4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2620 S Bristol St
Santa Ana, CA 92704
Phone (714) 545-5503

NPI Registry JSON

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

{
    "created_epoch": "1235001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244419200000",
    "number": "1740429422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11924",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927111924",
            "telephone_number": "714-835-3709",
            "fax_number": "714-836-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 S BRISTOL ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927045727",
            "telephone_number": "714-966-0904",
            "fax_number": "714-966-0972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COAST RADIOLOGY CENTER SOUTH COAST",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST COAST RADIOLOGY, INC.",
        "enumeration_date": "2009-02-19",
        "last_updated": "2009-06-08",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "714-835-6055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.