# COASTAL DIABETES CENTER LLC

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

## Provider details

- **NPI number:** 1841164167
- **Authorized official:** CASSIDY ROBINSON BSN-RN, CDCES (OWNER OPERATOR)
- **Authorized official phone:** (949) 266-4103

## Contact information

- **Practice address:** 486 CONSTITUTION AVE, CAMARILLO, CA 93012-8529
- **Practice address phone:** (949) 266-4103
- **Mailing address:** 486 CONSTITUTION AVE, CAMARILLO, CA 93012-8529
- **Mailing address phone:** (949) 266-4103

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 09/30/2025
- **Last updated:** 10/09/2025