Provider Demographics
NPI:1407138274
Name:SOUTH COUNTY EMERGENCY SPECIALISTS, INC
Entity Type:Organization
Organization Name:SOUTH COUNTY EMERGENCY SPECIALISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-364-2813
Mailing Address - Street 1:PO BOX 2567
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92690-0567
Mailing Address - Country:US
Mailing Address - Phone:949-364-2813
Mailing Address - Fax:949-364-2873
Practice Address - Street 1:23511 VIA ALONDRA
Practice Address - Street 2:
Practice Address - City:TRABUCO CANYON
Practice Address - State:CA
Practice Address - Zip Code:92679-3909
Practice Address - Country:US
Practice Address - Phone:949-364-2813
Practice Address - Fax:949-364-2873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-16
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty