Provider Demographics
NPI:1841000320
Name:SOUTH COAST URGENT CARE CENTER, INC
Entity type:Organization
Organization Name:SOUTH COAST URGENT CARE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROXANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MINKUS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:562-400-8774
Mailing Address - Street 1:PO BOX 1278
Mailing Address - Street 2:
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-6278
Mailing Address - Country:US
Mailing Address - Phone:562-400-8774
Mailing Address - Fax:
Practice Address - Street 1:2835 S BRISTOL ST STE B
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6238
Practice Address - Country:US
Practice Address - Phone:714-800-1919
Practice Address - Fax:714-800-1924
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTH COAST FAMILY MEDICINE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-08
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care