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Organization
COASTAL DIAGNOSTIC TESTING GROUP INC
Active
Organization
COASTAL DIAGNOSTIC TESTING GROUP INC
Active
Parent organization
COASTAL DIAGNOSTIC TESTING GROUP INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
COASTAL DIAGNOSTIC TESTING GROUP INC
Authorized official
MR. MEHRDAD GERAMI (PRESIDENT)
(541) 756-7710
Entity
Organization
Contact information
Practice address
615 CHETCO AVE, STE A, BROOKINGS, OR 97415
(541) 412-9556
(541) 756-7699
Mailing address
1957 THOMPSON RD, SUITE E, COOS BAY, OR 97420
(541) 756-7710
(541) 756-7699
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500719439
—
OR
Enumeration date
08/12/2021
Last updated
09/06/2023
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