Organization
COASTAL MEDICAL AND COSMETIC DERMATOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARRELL WAYNE GONZALES M.D. (OWNER, PRESIDENT, CFO)
(858) 657-0267
Entity
Organization
Contact information
Practice address
9850 GENESEE AVE STE 500, LA JOLLA, CA 92037-1213
(858) 657-0267
Mailing address
9850 GENESEE AVE STE 850, LA JOLLA, CA 92037-1213
(858) 657-0267
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A88738
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417960188
INDIVIDUAL NPI
—
Enumeration date
02/03/2009
Last updated
12/17/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us