COASTAL IMAGE GROUP NPI 1073759601

NPI Information

  • NPI: 1073759601
  • Provider Name: COASTAL IMAGE GROUP
  • Classification: Radiology - 2085U0001X
  • Specialization: Diagnostic Ultrasound
  • Entity Type: Organization
  • Address: 62 CORPORATE PARK STE 120
    IRVINE, CA
    ZIP 92606
  • Phone: (949) 701-3394

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NPI Details

COASTAL IMAGE GROUP is a diagnostic ultrasound radiology in Irvine, CA. The provider is a Radiology doctor of Osteopathy that specializes in Diagnostic Ultrasound. COASTAL IMAGE GROUP NPI is 1073759601. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

62 CORPORATE PARK STE 120
IRVINE, CA
ZIP 92606-142
Phone: (949) 701-3394
Fax: (949) 748-8868

The provider's authorized official is Ellen Teresa Song .
The authorized official title is President and has the following contact phone number (714) 904-5594.

The enumeration date for this NPI number is 1/3/2009 and was last updated on 1/3/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyA86825CALIFORNIANo
22085U0001XRadiologyDiagnostic UltrasoundA86825CALIFORNIAYes

What is NPI?

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This page was last updated on: 11/21/2025

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