Organization
COASTAL FAMILY DERMATOLOGY, PC
Active
Organization
COASTAL FAMILY DERMATOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE DENISE KILCLINE M.D. (M.D./OWNER)
(805) 544-5567
Entity
Organization
Contact information
Practice address
892 AEROVISTA PL STE 120, SAN LUIS OBISPO, CA 93401-8054
(805) 544-5567
(805) 544-3265
Mailing address
892 AEROVISTA PL STE 120, SAN LUIS OBISPO, CA 93401-8054
(805) 544-5567
(805) 544-3265
Taxonomy
Speciality
Code
Description
License number
State
207NP0225X
Pediatric Dermatology Physician
Primary
A72400
CA
207NS0135X
Procedural Dermatology Physician
A72400
CA
Other
Enumeration date
10/21/2014
Last updated
07/15/2025
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