SOUTH COAST OUTPATIENT SURGERY CENTER
NPI 1053545905
Clinic/Center - Ambulatory Surgical in Corona Del Mar, CA
- Organization
- Clinic/Center
- Ambulatory Surgical
- CLIA Number: 05D1092781
- CLIA Cert. Type: Ambulatory Surgery Center
- CLIA Exp. Date: 05-09-2028
About SOUTH COAST OUTPATIENT SURGERY CENTER
This page provides the complete NPI Profile along with additional information for South Coast Outpatient Surgery Center, a provider established in Corona Del Mar, California operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1053545905 assigned on May 2009. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 8 years ago. The provider's is doing business as South Coast Outpatient Surgery Center. The authorized official of this NPI record is Dr. Michael Wayne Niccole M.d. (Medical Director)
- NPI
- 1053545905 Verify this NPI
- Provider Legal Name
- SOUTH COAST OUTPATIENT SURG CTR BALBOA SURGERY CENTER
- Other Organization Name
- SOUTH COAST OUTPATIENT SURGERY CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1101 BAYSIDE DR SUITE 101 CORONA DEL MAR, CA 92625
- Location Phone
- (949) 718-6900
- Location Fax
- (949) 718-9367
- Mailing Address
- 1101 BAYSIDE DR STE 100 CORONA DEL MAR, CA 92625
- Mailing Phone
- (949) 718-6900
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-06-2009
- Last Update Date
- 10-30-2018
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Ambulatory Surgical
- Taxonomy Code
- 261QA1903X
- Type
- Ambulatory Health Care Facilities
- License State
- CA
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| F1929 | OTHER (01) | CA | PTAN |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D1092781
- Facility Type
- Ambulatory Surgery Center
- Certificate Effective Date
- May 10, 2026
- Certificate Expiration Date
- May 09, 2028
- Laboratory Director
- NICCOLE MICHAEL
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to South Coast Outpatient Surgery Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for SOUTH COAST OUTPATIENT SURGERY CENTER
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
Other Providers at the Same Location
The following 5 providers are registered at the same or a nearby location.
CORONA DEL MAR, CA 92625
CORONA DEL MAR, CA 92625
CORONA DEL MAR, CA 92625
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1053545905, enumerated as an "organization" on May 06, 2009.
The provider is located at 1101 BAYSIDE DR SUITE 101 CORONA DEL MAR, CA 92625 and the phone number is (949) 718-6900.
Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
