Organization
COAST INTERNAL MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE ANNE RYAN MD (PRESIDENT OWNER)
(562) 431-3535
Entity
Organization
Contact information
Practice address
10861 CHERRY STREET, SUITE 301, LOS ALAMITOS, CA 90720-5403
(562) 431-3535
(562) 431-6707
Mailing address
10861 CHERRY STREET SUITE 301, LOS ALAMITOS, CA 90720-5403
(562) 431-3535
(562) 431-3535
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0090910
—
CA
Enumeration date
01/02/2007
Last updated
08/22/2020
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