Provider Demographics
NPI:1285845867
Name:IRVINE COAST MRI MEDICAL GROUP
Entity Type:Organization
Organization Name:IRVINE COAST MRI MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-545-9441
Mailing Address - Street 1:1220 HEMLOCK WAY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92707-3650
Mailing Address - Country:US
Mailing Address - Phone:714-545-9441
Mailing Address - Fax:714-545-9486
Practice Address - Street 1:1220 HEMLOCK WAY
Practice Address - Street 2:SUITE 106
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92707-3650
Practice Address - Country:US
Practice Address - Phone:714-545-9441
Practice Address - Fax:714-545-9486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW9917Medicare PIN