Organization
TRI CITY COASTAL MEDICAL GROUP, INC
Active
Parent organization
GREATER TRI CITIES IPA
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREATER TRI CITIES IPA
Authorized official
MRS. GRACE BENDER (VICE PRESIDENT OF FINANCE)
(760) 941-7309
Entity
Organization
Contact information
Practice address
115 N EL CAMINO REAL STE A, OCEANSIDE, CA 92058-1844
(760) 941-7309
Mailing address
161 THUNDER DR STE 212, VISTA, CA 92083-6052
(760) 941-7309
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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