Organization
COASTLINE MEDICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHONG H TRAN MD (PRESIDENT)
(714) 531-7730
Entity
Organization
Contact information
Practice address
15606 BROOKHURST ST, STE A, WESTMINSTER, CA 92683-7581
(714) 531-7730
(714) 531-7793
Mailing address
PO BOX 9658, FOUNTAIN VALLEY, CA 92728-9658
(714) 531-7730
(714) 531-7793
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
11/08/2010
Last updated
12/29/2014
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