Organization
COASTAL ORTHOPEDICS & SPORTS MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RODMAN ST. CLAIR SR. M.D. (PRESIDENT)
(909) 605-8000
Entity
Organization
Contact information
Practice address
3998 VISTA WAY, SUITE B, OCEANSIDE, CA 92056-4514
(760) 724-5173
Mailing address
3998 VISTA WAY, SUITE B, OCEANSIDE, CA 92056-4514
(760) 724-5173
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
04/13/2009
Last updated
04/13/2009
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