Organization
COAST PHYSICAL MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARC CUBEIRO M.D. (PRESIDENT)
(714) 963-0955
Entity
Organization
Contact information
Practice address
10956 WARNER AVE, FOUNTAIN VALLEY, CA 92708-3853
(714) 963-0955
(714) 963-5775
Mailing address
17931 EUCLID ST, FOUNTAIN VALLEY, CA 92708-5409
(714) 963-0955
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
CA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
08/14/2014
Last updated
08/19/2019
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