COASTAL ENT MEDICAL GROUP INC (NPI# 1568542256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568542256 |
| Entity Type | Organization |
| Organization Name | COASTAL ENT MEDICAL GROUP INC |
| Other Organization Name | COASTAL ENT MEDICAL GROUP |
| Practice Address |
9834 Genesee Ave Suite 416 La Jolla CA 92037-1223 |
| Practice Telephone | 8584571287 |
| Practice Fax Number | 8584529160 |
| Mailing Telephone | 8584571287 |
| Mailing Fax Number | 8584529160 |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2012-11-25 |
| Authorized Official Name | DR. WILLIAM S. HALSEY (PRESIDENT) |
| Authorized Official Telephone | 8584581287 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
G30707 | CA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Coastal ENT Medical Group | Doing Business As Name - Organization |
| Street Address |
9834 GENESEE AVE SUITE 416 |
| City | LA JOLLA |
| State | CA |
| Zip Code | 92037-1223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437154143 | Mark M. Boiskin | Internal Medicine | 9834 Genesee Ave, Ste 312, La Jolla, CA 92037-1223 | 2005-06-17 |
| 1477925311 | Lee Copson | Audiologist-Hearing Aid Fitter | 9834 Genesee Ave, Hm Poole Building, Suite 224, La Jolla, CA 92037-1223 | 2015-10-29 |
| 1336531516 | Integrative Cardiovascular Center of La Jolla | Internal Medicine | 9834 Genesee Ave, Ste 101, La Jolla, CA 92037-1223 | 2015-02-25 |
| 1528460334 | Reinhard Wilhelm Schulte | Radiology | 9834 Genesee Ave, Suite 110, La Jolla, CA 92037-1223 | 2014-09-23 |
| 1083028898 | Frederick J De La Vega, Md | Specialist | 9834 Genesee Ave, 411, La Jolla, CA 92037-1223 | 2014-06-19 |
| 1912318023 | Ramona Master Md PC | Internal Medicine | 9834 Genesee Ave, La Jolla, CA 92037-1223 | 2014-05-12 |
| 1841632197 | Colleen Louise Trimlett | Physician Assistant | 9834 Genesee Ave, Ste. 125, La Jolla, CA 92037-1223 | 2013-07-26 |
| 1790120269 | California Hearing and Balance Center | Clinic/Center | 9834 Genesee Ave, Suite 111, La Jolla, CA 92037-1223 | 2013-05-09 |
| 1083972483 | Yogita Lakhera | Internal Medicine | 9834 Genesee Ave, Suite 312, La Jolla, CA 92037-1223 | 2012-04-24 |
| 1689948044 | Osteopathic Sports & Wellness Institute | Neuromusculoskeletal Medicine, Sports Medicine | 9834 Genesee Ave, Suite 125, La Jolla, CA 92037-1269 | 2012-03-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982221768 | Equip Health Medical, PC | Clinic/Center | 2674 Costebelle Drive, Unit A, La Jolla, CA 92037 | 2020-06-29 |
| 1134745474 | Brenda Kay Wiederhold | Psychologist | Virtual Reality Medical Center, 9834 Genesee Avenue, Suite 427, La Jolla, CA 92037 | 2020-06-23 |
| 1316581598 | Kathleen M Blechertas | Physical Therapist | 9888 Genesee, Lj19, La Jolla, CA 92037 | 2019-10-31 |
| 1316592876 | Kevin Yanyan Li | Student in an Organized Health Care Education/Training Program | 9300 Campus Point Drive, Mc7400, La Jolla, CA 92037 | 2019-08-01 |
| 1407400542 | Juan J Salmeron | Dentist | Callejin Internacional 351 L2, Los Algodones, BAJA CALIFORNIA 92037 | 2019-07-26 |
| 1609428598 | Nicole Whitney Mark | Physician Assistant | 8103 Caminito Sonoma, La Jolla, CA 92037 | 2019-07-11 |
| 1700357936 | Cecelia Rose Greene/pendzich | Mastectomy Fitter | 7760 Fay Ave, Suite M., La Jolla, CA 92037 | 2018-12-16 |
| 1740765890 | Jeenal Ankit Gordhandas | Student in an Organized Health Care Education/Training Program | East Campus Office Building, Medical Center Dr, La Jolla, CA 92037 | 2018-09-25 |
| 1306325220 | Lisa Beth Perlov Marks | Marriage & Family Therapist | 7734 Hershel Avenue, Suite O, La Jolla, CA 92037 | 2018-08-10 |
| 1023596731 | Uc San Diego, Pathology Dept | Pathology | East Campus Office Building, Medical Center Dr, San Diego, CA 92037 | 2018-08-03 |
| Find all providers in zip 92037 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942322862 | Edgar Huang Ling | Otolaryngology | 9834 Genesee Ave, Suite 220, La Jolla, CA 92037-1223 | 2007-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073159406 | Bh Ent Group Inc | Otolaryngology | 9033 Wilshire Blvd Ste 409, Beverly Hills, CA 90211-1847 | 2019-11-20 |
| 1942719570 | Beverly Hills Head and Neck Associates | Otolaryngology | 9401 Wilshire Blvd Ste 650, Beverly Hills, CA 90212-2913 | 2017-09-27 |
| 1083135065 | Jeffrey Jumaily Md Inc | Otolaryngology | 8816 Burton Way # 1, Beverly Hills, CA 90211-1715 | 2017-06-29 |
| 1558881771 | Bel Air Surgical Institute | Otolaryngology | 11847 Wilshire Blvd Ste 302, Los Angeles, CA 90025-6634 | 2017-06-20 |
| 1912371352 | Ent Surgical Specialists Inc. | Otolaryngology | 6424 W Olympic Blvd, Los Angeles, CA 90048-5347 | 2015-11-23 |
| 1437536216 | Kiersten L. Riedler | Otolaryngology | 5405 Oberlin Dr Fl 2, San Diego, CA 92121-1700 | 2015-04-30 |
| 1114344025 | Ryan M Casserly | Otolaryngology | 966 Cass St Ste 250, Monterey, CA 93940-4541 | 2014-03-28 |
| 1558798611 | Stephen Dow Proffitt | Otolaryngology | 172 Admiral Way, Costa Mesa, CA 92627-1397 | 2013-10-03 |
| 1447693973 | Jacob Lee Wester | Otolaryngology | 200 Medical Plaza Driveway Ste 550, Ucla Department of Head and Neck Surgery, Los Angeles, CA 90095-0001 | 2013-04-15 |
| 1417294174 | Entegrative Otolaryngology PC | Otolaryngology | 1144 Sonoma Ave Ste 101, Santa Rosa, CA 95405-4812 | 2013-01-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.