Organization
COASTAL FAMILY DERMATOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE DENISE KILCLINE (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
207N00000X
Dermatology Physician
—
—
207NP0225X
Pediatric Dermatology Physician
Primary
—
—
Other
Enumeration date
01/31/2019
Last updated
07/24/2025
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