| NPI | 1073590105 |
|---|---|
| Doing Business As | COASTAL ORTHOPAEDICS & SPORTS MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | JEANNETTE BRODY Billing Manager 760-724-1033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A70831) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA A70831) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A68137) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E4564) | |
| 363A00000X Physician Assistant (Licence: CA PA17120) | |
| 207X00000X Orthopaedic Surgery (Licence: CA A47884) | |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2008-07-29 |