Organization
COASTAL PODIATRY CLINIC
Active
Parent organization
RICHARD NORMAN
Other names
Coastal Podiatry Clinic, RICHARD J NORMAN DPM
Organization subpart
Yes
Provider details
NPI number
Legal business name
RICHARD NORMAN
Authorized official
RICHARD JAY NORMAN DPM (SOLE PROPRIETOR)
(805) 773-3668
Entity
Organization
Contact information
Practice address
2 JAMES WAY, SUITE 205, PISMO BEACH, CA 93449-4973
(805) 773-3668
(805) 773-1043
Mailing address
2 JAMES WAY, SUITE 205, PISMO BEACH, CA 93449-4973
(805) 773-3668
(805) 773-1043
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
E4306
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E4306
BOARD OF PODIATRIC MEDICINE LICENSE
CA
Enumeration date
03/03/2008
Last updated
06/21/2019
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