# COASTAL VASCULAR SPECIALISTS

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

## Provider details

- **NPI number:** 1417962895
- **Authorized official:** MARCELLO BORZATTA M.D. (OWNER / PHYSICIAN)
- **Authorized official phone:** (949) 218-7400

## Contact information

- **Practice address:** 26726 CROWN VALLEY PKWY, STE 220, MISSION VIEJO, CA 92691-8002
- **Practice address phone:** (949) 218-7400
- **Practice address fax:** (949) 218-9700
- **Mailing address:** 26012 MARGUERITE PKWY, H400, MISSION VIEJO, CA 92692-3263
- **Mailing address phone:** (949) 218-7400
- **Mailing address fax:** (949) 218-9700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | A40479 | CA | Yes |

## Other

- **Enumeration date:** 07/31/2006
- **Last updated:** 08/22/2020