South Coast Specialty Surgery Center, Inc.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

3919 Issued in CA

Legal business name

SOUTH COAST SPECIALTY SURGERY CENTER, INC.

Practice address

3420 Bristol St
Suite 750
Costa Mesa, CA 92626-7170

Phone

(714) 708-3737

Fax

(714) 708-3773

NPI assigned

Jul 29, 2010

Last updated

Jul 29, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Homan Mahallati, D.O.NPI 1215180765

Title

Medical Director

Phone

(714) 708-3737

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Homan Mahallati, D.O.

  • Family Medicine Physician
  • Pomona, CA
  • NPI 1215180765
  NPD (past) Authorized official

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

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280361600000",
    "number": "1932413176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 BRISTOL ST",
            "address_2": "SUITE 750",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926267170",
            "telephone_number": "714-708-3737",
            "fax_number": "714-708-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 BRISTOL ST",
            "address_2": "SUITE 750",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926267170",
            "telephone_number": "714-708-3737",
            "fax_number": "714-708-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH COAST SPECIALTY SURGERY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-29",
        "last_updated": "2010-07-29",
        "status": "A",
        "authorized_official_last_name": "MAHALLATI",
        "authorized_official_first_name": "HOMAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "714-708-3737",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "3919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Coast Behavioral Health Guesthouse Incorporation
• South Coast Children's Society, Inc
• South Coast Children's Society, Inc (Hope Healing Connection)
• South Coast Counseling, Inc.
• South Coast Rehabilitation Center
• South Coast Surgical Care, Inc.
• South Coast Traverse
• South Coast Wellness Inc
• South West Health Chiropractic Center Inc
• South West Health Radiology, Inc.

• Ambulatory Surgical Clinic/Center in Costa Mesa, CA
• Providers in Costa Mesa, 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 Jul 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.