Coastal Village Primary Care
LBN: Coastal Village Primary Care
Coastal Village Primary Care is an health care organization with primary practice located at 2 James Way Suite 209, Pismo Beach CA 93449-4976. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Coastal Village Primary Care can be contacted via phone (805) 773-7440, or through Cruz, Joseph A. via phone (805) 773-7440.
Contact Information
Primary practice address
2 James Way Suite 209
Pismo Beach CA 93449-4976
Phone: (805) 773-7440
Fax: (805) 773-7448
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | A49080 | California |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | A70251 | California |
Profile Details
| NPI number | 1992738496 |
|---|---|
| LBN Legal business name | Coastal Village Primary Care |
| DBA Doing business as | |
| Authorized official | Cruz, Joseph A. Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 8th, 2006 |
| Last updated | Sep 16th, 2011 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992738496 | NPPES |
| California | Other | ZZZ06670Z | BLUE SHIELD |
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