Organization
PRIMARY CARE ASSOCIATES MEDICAL GROUP, INC
Active
Other names
Coastal Orthopaedics & Sports Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JEANNETTE BRODY (BILLING MANAGER)
(760) 724-1033
Entity
Organization
Contact information
Practice address
3998 VISTA WAY, SUITE B, OCEANSIDE, CA 92056-4500
(760) 724-5173
(760) 724-5265
Mailing address
3998 VISTA WAY, SUITE B, OCEANSIDE, CA 92056-4500
(760) 724-5173
(760) 724-5265
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
A47884
CA
207X00000X
Orthopaedic Surgery Physician
Primary
A70831
CA
207XS0117X
Orthopaedic Surgery of the Spine Physician
A70831
CA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
A68137
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
E4564
CA
363A00000X
Physician Assistant
PA17120
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0089840
—
CA
Enumeration date
12/29/2005
Last updated
07/29/2008
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