COASTAL CARDIOLOGY A MEDICAL CORP (NPI# 1619127693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619127693 |
| Entity Type | Organization |
| Organization Name | COASTAL CARDIOLOGY A MEDICAL CORP |
| Other Organization Name | COASTAL CARDIOLOGY |
| Practice Address |
345 S Halcyon Rd Arroyo Grande CA 93420 |
| Mailing Address |
1941 Johnson Ave Ste 101 San Luis Obispo CA 93401-4154 |
| Practice Telephone | 8057828844 |
| Mailing Telephone | 8057828844 |
| Mailing Fax Number | 8057828859 |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2019-11-25 |
| Authorized Official Name | MELISSA GOSS (COO/PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 8057828844 |
| Authorized Official Credential | MHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | Other Service Providers | ||
| N | 207U00000X | Nuclear Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RR MEDICARE | CP1074 | 01 | |
| CA | GR0068680 | 05 | |
| CA | BLUE SHIELD | ZZZ24859Z | 01 |
| Other Name | Type Code |
|---|---|
| Coastal Cardiology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689836504 | Coastal Cardiology A Medical Corp | Internal Medicine | 295 Posada Lane Suite A, Templeton, CA 93465-4055 | 2008-07-01 |
| 1962664888 | Coastal Cardiology A Medical Corp | Internal Medicine | 1941 Johnson Ave Ste 102, San Luis Obispo, CA 93401-4154 | 2008-07-01 |
| 1578725495 | Coastal Cardiology A Medical Corp | Internal Medicine | 310 South Halcyon Road Ste 105, Arroyo Grande, CA 93420-3872 | 2008-07-01 |
| 1720183569 | Coastal Cardiology A Medical Corp | Internal Medicine | 1941 Johnson Ave Ste 101, San Luis Obispo, CA 93401-4154 | 2006-09-14 |
| Street Address |
345 S HALCYON RD |
| City | ARROYO GRANDE |
| State | CA |
| Zip Code | 93420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487640470 | Andrew D Sun | Anesthesiology | 345 S Halcyon Rd, Arroyo Grande, CA 93420-3896 | 2005-09-23 |
| 1558983510 | Elizabeth Henrichs | Occupational Therapist | 345 S Halcyon Rd, Arroyo Grande, CA 93420-3817 | 2020-05-13 |
| 1023630514 | Excellence In Rehabilitation Medical Group Inc | Physical Medicine & Rehabilitation | 345 S Halcyon Rd, Arroyo Grande, CA 93420-3899 | 2020-05-07 |
| 1881257608 | Angel Charissa Evans | Social Worker | 345 S Halcyon Rd, Arroyo Grande, CA 93420-3817 | 2019-04-17 |
| 1306334719 | Knd Development 59, LLC | Hospitalist | 345 S Halcyon Rd, Arroyo Grande, CA 93420-3817 | 2018-05-01 |
| 1871039909 | Stephanie Pulikkottil Joseph M.d. Medical Corporation | Physical Medicine & Rehabilitation | 345 S Halcyon Rd, Arroyo Grande, CA 93420-3817 | 2017-01-12 |
| 1427409929 | Larry Foreman, Do | Emergency Medicine | 345 S Halcyon Rd, Arroyo Grande, CA 93420-3817 | 2016-06-27 |
| 1386058030 | Sharon Peach Corporation | Specialist | 345 S Halcyon Rd, Arroyo Grande, CA 93420-3817 | 2014-06-19 |
| 1619395720 | Wellness & Rehabilitation Medicine, Inc. | Physical Medicine & Rehabilitation | 345 S Halcyon Rd, Arroyo Grande, CA 93420-3817 | 2014-04-04 |
| 1164868873 | Brent Michael Pennelly | Physical Medicine & Rehabilitation | 345 S Halcyon Rd, Arroyo Grande, CA 93420 | 2013-05-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992337174 | Element Nutrition Company, LLC | Dietitian, Registered | 405 E. Branch St. #102, Arroyo Grande, CA 93420 | 2020-02-06 |
| 1861965055 | Pacific Central Coast Health Centers | Clinic/Center | 850 Fair Oaks Ave Ste 310, Arroyo Grande, CA 93420 | 2019-01-10 |
| 1629552815 | Leanne Marie Ford | Physician Assistant | 536 Camino Mercado, Arroyo Grande, CA 93420 | 2018-09-24 |
| 1730662107 | Kelli Thompson Hamma | Massage Therapist | 630 Lancaster Dr, Arroyo Grande, CA 93420 | 2018-09-12 |
| 1063962595 | Suzanne Erickson | Social Worker | 2820 Poquito Place, Arroyo Grande, CA 93420 | 2016-10-07 |
| 1255888459 | Anka Behavioral Health, Inc. | Community/Behavioral Health | 2119 Lopez Dr, Arroyo Grande, CA 93420 | 2016-09-06 |
| 1225585664 | Tikva Treatment | Substance Abuse Rehabilitation Facility | 170 Nelson Street, Suite 102, Arroyo Grande, CA 93420 | 2016-09-01 |
| 1831541986 | Tikva Treatment LLC | Clinic/Center | 621 E Grande Ave, Arroyo Grande, CA 93420 | 2016-07-12 |
| 1255788543 | David E. Yocum, M.d., A Medical Corporation | Internal Medicine | 860 Oak Park Blvd., #204, Arroyo Grande, CA 93420 | 2016-05-17 |
| 1689059800 | David Hikaru Lindsey | Dentist | 203 Station Way, Arroyo Grande, CA 93420 | 2015-07-29 |
| Find all providers in zip 93420 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578725495 | Coastal Cardiology A Medical Corp | Internal Medicine | 310 South Halcyon Road Ste 105, Arroyo Grande, CA 93420-3872 | 2008-07-01 |
| 1578598488 | Peter A Thom | Internal Medicine | 405 Traffic Way, Suite A, Arroyo Grande, CA 93420-3346 | 2006-07-11 |
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| 1962000141 | Suman S Kuppahally, M.d. Inc | Internal Medicine | 2505 Samaritan Dr Ste 600, San Jose, CA 95124-4017 | 2020-10-11 |
| 1336754472 | Ankur Gupta Medical Corporation | Internal Medicine | 820 S Akers St Ste 130, Visalia, CA 93277-8346 | 2020-09-15 |
| 1295351740 | Penciu Medical Apmc | Internal Medicine | 1585 Sierra Madre Villa Ave, Pasadena, CA 91107-1259 | 2020-06-21 |
| 1679113336 | La Pulse Medical, Inc | Internal Medicine | 14558 Sylvan St Ste 105, Van Nuys, CA 91411-2324 | 2020-01-10 |
| 1770122871 | John R. Nelson M.d. Inc. | Internal Medicine | 7061 N Whitney Ave Ste 101, Fresno, CA 93720-8025 | 2020-01-06 |
| 1730725789 | Norcal Medical Services, Inc | Internal Medicine | 2267 Lava Ridge Ct, Roseville, CA 95661-3062 | 2019-11-25 |
| 1932750957 | Enloe Medical Center | Internal Medicine | 1430 Esplanade Ste 6, Chico, CA 95926-3366 | 2019-09-20 |
| 1528610425 | Nicholas Russell | Internal Medicine | 2967 N Moorpark Rd, Thousand Oaks, CA 91360-4573 | 2019-07-10 |
| 1043871627 | Gy Medical Clinic Inc | Internal Medicine | 7400 Van Nuys Blvd Ste 112, Van Nuys, CA 91405-1972 | 2019-06-25 |
| 1902465792 | Pacific Heart & Vascular | Internal Medicine | 1234 W. Chapman Ave, Ste #101, Orange, CA 92868-2862 | 2019-06-06 |
| Find all providers with the same taxonomy | ||||
| City | ARROYO GRANDE |
| Zip Code | 93420 |
Please comment or provide details below to improve the information on COASTAL CARDIOLOGY A MEDICAL CORP.
| 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.