# COASTAL ORTHOPEDIC & SPINE INSTITUTE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144091828
- **Authorized official:** CANDICE BRADY DO (PRESIDENT)
- **Authorized official phone:** (313) 580-5495

## Contact information

- **Practice address:** 400 CAMARILLO RANCH RD STE 101, CAMARILLO, CA 93012-5901
- **Practice address phone:** (805) 273-5478
- **Mailing address:** 400 CAMARILLO RANCH RD STE 101, CAMARILLO, CA 93012-5901

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/11/2024
- **Last updated:** 01/11/2024