| NPI | 1124131065 |
|---|---|
| Other Name | COASTAL VISION MEDICAL GROUP |
| Doing Business As | COASTAL VISION MEDICAL GROUP, INC. |
| Entity Type | Organization |
| Authorized Contact | MICHELE M STEPP Credentialing 714-771-1213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA g83738) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA OP12694) |
| 152W00000X Optometrist (Licence: CA 13026TPA) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2023-05-03 |