Organization
COASTAL FAMILY MEDICINE, INC
Active
Other names
Family Care Centers Medical Group, Family Care Centers
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID S KIM MD (PRESIDENT)
(657) 241-3500
Entity
Organization
Contact information
Practice address
660 BAKER ST STE A101, COSTA MESA, CA 92626-4407
(714) 668-2500
(714) 668-2515
Mailing address
PO BOX 2218, SUISUN CITY, CA 94585-5218
(657) 241-3600
(657) 241-7708
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
CA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
CA
208D00000X
General Practice Physician
—
CA
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
CA
363L00000X
Nurse Practitioner
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE5878
MEDICARE RAILROAD
CA
Enumeration date
05/15/2006
Last updated
02/21/2024
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