Organization
COASTAL DETOX OF SOUTHERN CALIFORNIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MERCEDES CORNEJO (CEO)
(949) 356-5301
Entity
Organization
Contact information
Practice address
2574 PICO WAY, SAN DIEGO, CA 92109-3811
(619) 386-7740
Mailing address
2574 PICO WAY, SAN DIEGO, CA 92109-3811
(619) 386-7740
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
370207AP
DHCS
CA
Enumeration date
08/31/2022
Last updated
07/23/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up