Organization
COAST PAIN AND SPINE INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS UNTAL (PARTNER)
(310) 792-3914
Entity
Organization
Contact information
Practice address
1800 E GRAND AVE STE L2, GROVER BEACH, CA 93433-5222
(805) 710-9465
Mailing address
PO BOX 3129, TORRANCE, CA 90510-3129
(310) 792-3914
(855) 898-4055
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Enumeration date
02/01/2024
Last updated
02/01/2024
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