# LAKEWOOD IPA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Coast Healthcare Management, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568994028
- **Authorized official:** MRS. KATHRYNE MCGOWAN (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (562) 602-1563

## Contact information

- **Practice address:** 10833 VALLEY VIEW ST, SUITE 300, CYPRESS, CA 90630-5046
- **Practice address phone:** (562) 602-1563
- **Mailing address:** 10833 VALLEY VIEW ST, SUITE 300, CYPRESS, CA 90630-5046
- **Mailing address phone:** (562) 602-1563

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | — | CA | Yes |

## Other

- **Enumeration date:** 04/03/2017
- **Last updated:** 04/03/2017