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COAST PULMONARY & INTERNAL MEDICINE ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JILL ROELL (OFFICE MANAGER)
(714) 545-8700
Entity
Organization

Contact information

Practice address
9940 TALBERT AVE, SUITE 101, FOUNTAIN VALLEY, CA 92708-5153
(714) 545-8700
(714) 545-8084
Mailing address
9940 TALBERT AVE, SUITE 101, FOUNTAIN VALLEY, CA 92708-5153
(714) 545-8700
(714) 545-8084

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
A75677
CA
207RP1001X
Pulmonary Disease Physician
A37535
CA
207RP1001X
Pulmonary Disease Physician
Primary
G26245
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GR0019730
CA
Enumeration date
03/26/2007
Last updated
08/12/2011
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