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Organization
PACIFIC COAST MEDICAL SUPPLIES
Active
Organization
PACIFIC COAST MEDICAL SUPPLIES
Active
Other names
Gold Coast Diabetes Resource, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CARIE FRANCES MORTENSEN (CEO/PRESIDENT)
(562) 706-4552
Entity
Organization
Contact information
Practice address
1704 W. MANCHESTER AVE., SUITE 105, LOS ANGELES, CA 90047-3327
(562) 706-4552
(877) 733-3462
Mailing address
218 CHICAGO AVE, SUITE 8, HUNTINGTON BEACH, CA 92648
(562) 706-4552
(877) 733-3462
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
CA
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Enumeration date
04/01/2009
Last updated
04/29/2015
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