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Coastline Medical Clinic INC

in Westminster, CA. Organization (NPI-2).

NPI number1013218007
StatusActive
Last updated in NPPESDec 29, 2014

Details

NPI
1013218007
Entity type
Organization (NPI-2)
Legal business name
Coastline Medical Clinic INC
Organization subpart
No
Enumeration date
Nov 8, 2010
Last updated
Dec 29, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208VP0000X ––Yes

Practice location

15606 Brookhurst St
Ste A
Westminster, CA 92683-7581

Phone 714-531-7730 · Fax 714-531-7793

Mailing address

Po Box 9658
Fountain Valley, CA 92728-9658

Phone 714-531-7730 · Fax 714-531-7793

Authorized official

Phong H Tran
President
7145317730

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