Organization
COAST UROLOGICAL MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN ANTHONY HIGHTOWER (PRESIDENT)
(562) 430-0581
Entity
Organization
Contact information
Practice address
3771 KATELLA AVE STE 210, LOS ALAMITOS, CA 90720
(562) 430-0581
(562) 598-2110
Mailing address
3771 KATELLA AVE STE 210, LOS ALAMITOS, CA 90720-3118
(562) 430-0581
(562) 598-2110
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ75909Z
—
CA
Enumeration date
09/27/2006
Last updated
08/03/2018
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