Organization
COACHCARE MSO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA LORELLA (VP STRATEGY)
(917) 336-1205
Entity
Organization
Contact information
Practice address
1246 19TH ST, HERMOSA BEACH, CA 90254-3308
(917) 324-9942
Mailing address
211 E 43RD ST FL 7250, NEW YORK, NY 10017-4707
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
01/06/2025
Last updated
01/06/2025
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