Organization
COASTAL FAMILY MEDICINE, INC
Active
Other names
Family Care Centers Medical Group, Family Care Centers
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID S KIM (PRESIDENT)
(657) 241-3500
Entity
Organization
Contact information
Practice address
18785 BROOKHURST ST STE 101, FOUNTAIN VALLEY, CA 92708-7300
(714) 378-0042
(714) 968-9129
Mailing address
PO BOX 2218, SUISUN CITY, CA 94585-5218
(657) 241-3600
(657) 241-7708
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
208D00000X
General Practice Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE5878
MEDICARE RAILROAD
CA
Enumeration date
08/01/2014
Last updated
02/21/2024
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