Organization · NPI-2

Coastal Vascular Specialists

· Mission Viejo, CA

NPI number1417962895
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1417962895
Entity type
Organization (NPI-2)
Legal business name
Coastal Vascular Specialists
Organization subpart
No
Enumeration date
Jul 31, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2086S0129X a40479CAYes

Practice location

26726 Crown Valley Pkwy
Ste 220
Mission Viejo, CA 92691-8002

Phone 949-218-7400 · Fax 949-218-9700

Mailing address

26012 Marguerite Pkwy
H400
Mission Viejo, CA 92692-3263

Phone 949-218-7400 · Fax 949-218-9700

Authorized official

Marcello Borzatta
Owner / Physician
9492187400

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