# COAST MEDICAL SERVICE & SUPPLIES INC

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

## Provider details

- **NPI number:** 1487062782
- **Authorized official:** MEHRDAD GERAMI (CEO)
- **Authorized official phone:** (541) 260-3471

## Contact information

- **Practice address:** 22762 ASPAN ST, STE 205B, LAKE FOREST, CA 92630-1604
- **Practice address phone:** (541) 260-3471
- **Practice address fax:** (541) 756-7716
- **Mailing address:** 22762 ASPAN ST, STE 205B, LAKE FOREST, CA 92630-1604
- **Mailing address phone:** (541) 260-3471
- **Mailing address fax:** (541) 756-7716

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 07/30/2014
- **Last updated:** 07/30/2014