Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

South Coast Outpatient Surg Ctr Balboa Surgery Center

Organization Ambulatory Surgical Clinic/Center · NPI 1053545905

South Coast Outpatient Surg Ctr Balboa Surgery Center is an Ambulatory Surgical Clinic/Center in Corona del Mar, California. Licensed in California. Registered with an NPI since 2009.

Licensed in
CA
In the registry since
2009

Practice location Address checks out

1101 Bayside Dr Ste 101
Corona del Mar, CA 92625-1702
Phone: (949) 718-6900
Fax: (949) 718-9367
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ambulatory Surgical Clinic/Center (primary) Taxonomy 261QA1903X (CA)

Record details

NPI number1053545905
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Niccole — Medical Director · (310) 792-3914
Other names South Coast Outpatient Surgery Center
NPI enumeratedMay 6, 2009
Last updated in NPPESOctober 30, 2018
Mailing address1101 Bayside Dr Ste 100, Corona Del Mar, CA 92625-1754

Other providers in Corona del Mar