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Organization

COAST SURGICAL GROUP, A MEDICAL CORPORATION

Active
Other names
COAST SURGICAL GROUP, AMC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. FRANCISCO ANTONIO HERNANDEZ M.D. (PRESIDENT)
(619) 425-0797
Entity
Organization

Contact information

Practice address
786 3RD AVE, SUITE B, CHULA VISTA, CA 91910-5826
(619) 425-0797
(619) 425-0596
Mailing address
786 3RD AVE, SUITE B, CHULA VISTA, CA 91910-5826
(619) 425-0797
(619) 425-0596

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GR0062500
CA
Enumeration date
09/21/2006
Last updated
04/07/2015
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