Organization
COASTAL FUNCTIONAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDRA FLEMING MD (CEO)
(707) 440-9898
Entity
Organization
Contact information
Practice address
17800 FREITAS LN, FORT BRAGG, CA 95437-8329
(707) 440-9898
Mailing address
17800 FREITAS LN, FORT BRAGG, CA 95437-8329
(707) 440-9898
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/06/2021
Last updated
08/06/2021
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