# COASTAL ENT MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Coastal ENT Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568542256
- **Authorized official:** DR. WILLIAM S. HALSEY MD (PRESIDENT)
- **Authorized official phone:** (858) 458-1287

## Contact information

- **Practice address:** 9834 GENESEE AVE, SUITE 416, LA JOLLA, CA 92037-1223
- **Practice address phone:** (858) 457-1287
- **Practice address fax:** (858) 452-9160
- **Mailing address:** 9834 GENESEE AVE, SUITE 416, LA JOLLA, CA 92037-1223
- **Mailing address phone:** (858) 457-1287
- **Mailing address fax:** (858) 452-9160

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | G30707 | CA | Yes |

## Other

- **Enumeration date:** 10/16/2006
- **Last updated:** 11/25/2012