| Pacific Coast Heart Center A Professional Medical Corp | |
|
30131 Town Center Dr Suite 237 Laguna Niguel CA 92677 | |
| (949) 495-0800 | |
| (949) 495-0805 |
| Full Name | Pacific Coast Heart Center A Professional Medical Corp |
|---|---|
| Speciality | Clinic/Center |
| Location | 30131 Town Center Dr, Laguna Niguel, California |
| Authorized Official Name and Position | Christine M. Theard (PRESIDENT) |
| Authorized Official Contact | 9494950800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Coast Heart Center A Professional Medical Corp 30131 Town Center Dr Suite 237 Laguna Niguel CA 92677 Ph: (949) 495-0800 | Pacific Coast Heart Center A Professional Medical Corp 30131 Town Center Dr Suite 237 Laguna Niguel CA 92677 Ph: (949) 495-0800 |
| NPI Number | 1841416435 |
|---|---|
| Provider Enumeration Date | 04/18/2007 |
| Last Update Date | 11/22/2013 |
| Medicare PECOS PAC ID | 8325931660 |
|---|---|
| Medicare Enrollment ID | O20040202001242 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841416435 | NPI | - | NPPES |
| WC50353A | Other | CA | MEDICARE INDIVIDUAL PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Christine M Theard |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1356410740 PECOS PAC ID: 2961395207 Enrollment ID: I20040204000743 |
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