# COAST PAIN AND SPINE INSTITUTE

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

## Provider details

- **NPI number:** 1598528598
- **Authorized official:** CARLOS UNTAL (PARTNER)
- **Authorized official phone:** (310) 792-3914

## Contact information

- **Practice address:** 1800 E GRAND AVE STE L2, GROVER BEACH, CA 93433-5222
- **Practice address phone:** (805) 710-9465
- **Mailing address:** PO BOX 3129, TORRANCE, CA 90510-3129
- **Mailing address phone:** (310) 792-3914
- **Mailing address fax:** (855) 898-4055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | — |
| 207L00000X | Anesthesiology Physician | — | — | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |

## Other

- **Enumeration date:** 02/01/2024
- **Last updated:** 02/01/2024