Organization
COASTAL WELLNESS MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER T BRADBURN D.O (PRESIDENT)
(805) 434-5222
Entity
Organization
Contact information
Practice address
292 POSADA LN, SUITE A, TEMPLETON, CA 93465-4054
(805) 434-5222
Mailing address
1310 LAS TABLAS RD, SUITE 207, TEMPLETON, CA 93465-9737
(805) 369-1305
(805) 369-1309
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
20A7376
CA
Other
Enumeration date
04/23/2008
Last updated
04/28/2008
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