Organization
COASTAL VASCULAR MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EHAB NABIL HANNA MADY (OWNER)
(949) 631-6002
Entity
Organization
Contact information
Practice address
320 SUPERIOR AVE STE 250, NEWPORT BEACH, CA 92663-2778
(949) 631-6002
(949) 631-6982
Mailing address
320 SUPERIOR AVE STE 250, NEWPORT BEACH, CA 92663-2778
(949) 631-6002
(949) 631-6982
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207R00000X
Internal Medicine Physician
10166
CA
207R00000X
Internal Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/23/2014
Last updated
02/20/2025
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