Provider Demographics
NPI:1912020629
Name:WEST COAST BREAST CENTER-IRVINE
Entity Type:Organization
Organization Name:WEST COAST BREAST CENTER-IRVINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LASZLO
Authorized Official - Middle Name:P
Authorized Official - Last Name:KAVEGGIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-835-6055
Mailing Address - Street 1:16300 SAND CANYON AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3711
Mailing Address - Country:US
Mailing Address - Phone:949-753-9090
Mailing Address - Fax:949-753-9030
Practice Address - Street 1:16300 SAND CANYON AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3711
Practice Address - Country:US
Practice Address - Phone:949-753-9090
Practice Address - Fax:949-753-9030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Not Answered2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
228256OtherFDA FACILITY ID NUMBER
CA57485OtherDHS