# COASTLINE PAIN CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COASTLINE PAIN CENTER
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1639491228
- **Legal business name:** COASTLINE PAIN CENTER
- **Authorized official:** PHONG TRAN M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (714) 531-7730

## Contact information

- **Practice address:** 15606 BROOKHURST ST STE A, WESTMINSTER, CA 92683-7582
- **Practice address phone:** (714) 531-7730
- **Mailing address:** 2980 N BEVERLY GLEN CIR STE 101, LOS ANGELES, CA 90077-1726
- **Mailing address phone:** (310) 474-9809

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | Yes |

## Other

- **Enumeration date:** 02/23/2010
- **Last updated:** 03/01/2011