# SETON MEDICAL CENTER COATSIDE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SETON MEDICAL CENTER COASTSIDE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740374008
- **Authorized official:** MRS. MARTHA E YASAVOLIAN PHARM.D. (DIRECTOR OF PHARMACY)
- **Authorized official phone:** (650) 991-6488

## Contact information

- **Practice address:** 600 MARINE BLVD, MOSS BEACH, CA 94038-9641
- **Practice address phone:** (650) 991-6488
- **Practice address fax:** (650) 991-6683
- **Mailing address:** 1900 SULLIVAN AVE, DALY CITY, CA 94015-2229
- **Mailing address phone:** (650) 991-6488
- **Mailing address fax:** (650) 991-6683

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336I0012X | Institutional Pharmacy | HSP45702 | CA | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 10/03/2006
- **Last updated:** 07/13/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0555877 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |