Provider Demographics
NPI:1295731586
Name:SOUTH COAST NUCLEAR MEDICINE
Entity type:Organization
Organization Name:SOUTH COAST NUCLEAR MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:RIMKUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-563-5744
Mailing Address - Street 1:229 W PUEBLO ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3804
Mailing Address - Country:US
Mailing Address - Phone:805-563-5744
Mailing Address - Fax:805-563-5747
Practice Address - Street 1:229 W PUEBLO ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3804
Practice Address - Country:US
Practice Address - Phone:805-563-5744
Practice Address - Fax:805-563-5747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization