| South Coast Family Medicine, Inc | |
|
2650 S Bristol St 105 Santa Ana CA 92704-5751 | |
| (714) 800-1919 | |
| (714) 800-1924 |
| Full Name | South Coast Family Medicine, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2650 S Bristol St, Santa Ana, California |
| Authorized Official Name and Position | Roxana P Minkus (FAMILY PRACTICE) |
| Authorized Official Contact | 7148001919 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Coast Family Medicine, Inc 2650 S Bristol St 105 Santa Ana CA 92704-5751 Ph: (714) 800-1919 | South Coast Family Medicine, Inc 2650 S Bristol St 105 Santa Ana CA 92704-5751 Ph: (714) 800-1919 |
| NPI Number | 1821115817 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 12/13/2019 |
| Medicare PECOS PAC ID | 4183886856 |
|---|---|
| Medicare Enrollment ID | O20120426000237 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821115817 | NPI | - | NPPES |
| 00AX66720A | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Roxana P Minkus |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1184669871 PECOS PAC ID: 8123081361 Enrollment ID: I20041108001297 |
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