Provider Demographics
NPI:1841203247
Name:PACIFIC COAST ULTRASOUND, INC.
Entity Type:Organization
Organization Name:PACIFIC COAST ULTRASOUND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:GINNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-596-3428
Mailing Address - Street 1:4622 KATELLA AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-2677
Mailing Address - Country:US
Mailing Address - Phone:562-596-3428
Mailing Address - Fax:562-596-3438
Practice Address - Street 1:4622 KATELLA AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-2677
Practice Address - Country:US
Practice Address - Phone:562-596-3428
Practice Address - Fax:562-596-3438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology