Organization
GROSSMONT DERMATOLOGY MEDICAL CLINIC
Active
Organization
GROSSMONT DERMATOLOGY MEDICAL CLINIC
Active
Parent organization
COASTAL SKIN AND EYE INSTITUTE
Other names
Coastal Skin and Eye Institute
Organization subpart
Yes
Provider details
NPI number
Legal business name
COASTAL SKIN AND EYE INSTITUTE
Authorized official
MONICA DEL VALLE (BILLING SUPERVISOR)
(619) 462-1670
Entity
Organization
Contact information
Practice address
8860 CENTER DR, STE 300, LA MESA, CA 91942-3068
(619) 462-1670
(619) 462-3209
Mailing address
8860 CENTER DR STE 300, LA MESA, CA 91942-7001
(619) 462-1670
(619) 462-3209
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207NS0135X
Procedural Dermatology Physician
Primary
—
—
207W00000X
Ophthalmology Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A233400
—
CA
05
—
00G733400
—
CA
Enumeration date
08/17/2006
Last updated
09/30/2025
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