Provider Demographics
NPI:1306539101
Name:SOUTH COAST ACUPUNCTURE, INC.
Entity type:Organization
Organization Name:SOUTH COAST ACUPUNCTURE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:S
Authorized Official - Last Name:AZIZI
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:714-953-6000
Mailing Address - Street 1:2001 E 1ST ST STE 110
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-4020
Mailing Address - Country:US
Mailing Address - Phone:714-953-6000
Mailing Address - Fax:714-953-6025
Practice Address - Street 1:2001 E 1ST ST STE 110
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-4020
Practice Address - Country:US
Practice Address - Phone:714-953-6000
Practice Address - Fax:714-953-6025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty