COASTAL ENT MEDICAL GROUP INC NPI 1568542256

NPI Information

COASTAL ENT MEDICAL GROUP INC is an otolaryngology/facial plastic surgery otolaryngology in La Jolla, CA. The provider is an otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. COASTAL ENT MEDICAL GROUP INC NPI is 1568542256. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Coastal Ent Medical Group.

The provider's business location address is:

9834 GENESEE AVE
SUITE 416
LA JOLLA, CA
ZIP 92037-223
Phone: (858) 457-1287
Fax: (858) 452-9160

The provider's authorized official is William S. Halsey .
The authorized official title is President and has the following contact phone number (858) 458-1287.

The enumeration date for this NPI number is 10/16/2006 and was last updated on 11/25/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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