Organization
GOLD COAST NEONATAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARA NORDBERG (ACCOUNTS ADMINISTRATOR)
(949) 492-3514
Entity
Organization
Contact information
Practice address
3291 LOMA VISTA RD, VENTURA, CA 93003-3099
(805) 652-6084
(949) 366-2390
Mailing address
PO BOX 1359, SAN CLEMENTE, CA 92674-1359
(949) 492-3514
(949) 366-2390
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0097050
—
CA
Enumeration date
12/04/2006
Last updated
08/22/2020
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