COASTAL CARDIOLOGY A MEDICAL CORP (NPI# 1689836504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689836504 |
| Entity Type | Organization |
| Organization Name | COASTAL CARDIOLOGY A MEDICAL CORP |
| Practice Address |
295 Posada Lane Suite A Templeton CA 93465-4055 |
| Mailing Address |
1941 Johnson Ave Ste 101 San Luis Obispo CA 93401-4154 |
| Practice Telephone | 8057828844 |
| Practice Fax Number | 8055405827 |
| Mailing Telephone | 8057828844 |
| Mailing Fax Number | 8055405827 |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2019-10-29 |
| Authorized Official Name | MS. MELISSA L 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 | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
G58530 | CA | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
A99253 | CA | Allopathic & Osteopathic Physicians |
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
G69997 | CA | Allopathic & Osteopathic Physicians |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA23186 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
G44009 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0068680 | 05 | |
| CA | RR MEDICARE | CP1074 | 01 |
| CA | BLUE SHIELD | ZZZ40450Z | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1619127693 | Coastal Cardiology A Medical Corp | Specialist | 345 S Halcyon Rd, Arroyo Grande, CA 93420 | 2008-09-25 |
| 1720183569 | Coastal Cardiology A Medical Corp | Internal Medicine | 1941 Johnson Ave Ste 101, San Luis Obispo, CA 93401-4154 | 2006-09-14 |
| Street Address |
295 POSADA LANE SUITE A |
| City | TEMPLETON |
| State | CA |
| Zip Code | 93465-4055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346773306 | Edward Delos Trino | Nurse Practitioner | 350 Posada Ln # 102, Templeton, CA 93465 | 2017-04-06 |
| 1497102883 | Miriam Castillo | Counselor | 44 Brewer St, Templeton, CA 93465 | 2016-05-16 |
| 1013395821 | Marna Moore-barr | Registered Nurse | 90 Dandelion Ln, Templeton, CA 93465 | 2015-05-12 |
| 1396007308 | Melissa Lee Gaidis | Psychologist | 225 Posada Lane, Suite L, Templeton, CA 93465 | 2012-06-14 |
| 1033418736 | Central Coast Associated Physicians, Inc. | Internal Medicine | 1220 Las Tablas Rd, Suite 1418, Templeton, CA 93465 | 2011-03-21 |
| 1922306281 | Benjamin Ernest Bartel | Counselor | 1827 Orlen Lane, Templeton, CA 93465 | 2011-03-09 |
| 1003116674 | Tiffney Taylor | Internal Medicine | 265 Posada Ln Ste B, Templeton, CA 93465 | 2010-10-28 |
| 1124355342 | Mary Christine Schaff | Nurse Practitioner | 1111 Las Tablas Rd., Ste. M, Templeton, CA 93465 | 2009-11-09 |
| 1417196890 | Liberty Michael Romig | Marriage & Family Therapist | 318 Crocker Street, Templeton, CA 93465 | 2009-02-09 |
| 1427212273 | Linda Kay Shaleen | Social Worker | 212 Main Street Suite 201, Templeton, CA 93465 | 2008-07-10 |
| Find all providers in zip 93465 | ||||
| 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 |
|---|---|---|---|---|
| 1013085810 | Andrew S Dennish | Internal Medicine | 295 Posada Ln, Suite A, Templeton, CA 93465 | 2006-12-01 |
| 1023109048 | Lawrence E Vondollen | Internal Medicine | 295 Posada Ln, Ste A, Templeton, CA 93465-4055 | 2006-09-27 |
| 1104805837 | Michael L Wiechmann | Internal Medicine | 295 Posada Ln, Ste A, Templeton, CA 93465 | 2006-01-11 |
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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.