| NPI | 1821673062 |
|---|---|
| Doing Business As | COAST MEDICAL AND BOTOX |
| Entity Type | Organization |
| Authorized Contact | JEFFREY CRUDO Owner 949-715-6890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2021-03-09 |
| Last Update Date | 2021-08-17 |