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COASTSIDE HEALTH AND MEDICAL CLINIC INC. NPI 1700253556


NPI Information

NPI: 1700253556
Provider Name: COASTSIDE HEALTH AND MEDICAL CLINIC, INC.
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
1618 SULLIVAN AVE
#208
DALY CITY, CA
ZIP 94015
Phone: (650) 994-4444
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COASTSIDE HEALTH AND MEDICAL CLINIC, INC. is a primary care clinic center in Daly City, CA. COASTSIDE HEALTH AND MEDICAL CLINIC, INC. NPI is 1700253556. The provider is registered as an organization entity type.

The provider's business location address is:

1618 SULLIVAN AVE
#208
DALY CITY, CA
ZIP 94015-967
Phone: (650) 994-4444
Fax: (650) 994-3051

The provider's authorized official is Christopher Hermanson .
The authorized official title is Medical Officer and has the following contact phone number (650) 994-4444.

The enumeration date for this NPI number is 8/27/2015 and was last updated on 8/27/2015.


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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareA67810CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1H18020MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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