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Organization
COASTAL COMMUNITIES PHYSICIAN NETWORK, INC.
Active
Organization
COASTAL COMMUNITIES PHYSICIAN NETWORK, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JU HUAN LEE M.D. (MEDICAL DIRECTOR)
(661) 327-4411
Entity
Organization
Contact information
Practice address
35 CASA ST STE 170, SAN LUIS OBISPO, CA 93405-1887
(805) 549-0677
(805) 549-7588
Mailing address
4580 CALIFORNIA AVE, BAKERSFIELD, CA 93309-1104
(805) 549-0677
(805) 549-7588
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
30221170
CA
Other
Enumeration date
06/04/2007
Last updated
07/21/2015
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