Organization
PACIFIC COAST MEDICAL GROUP COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAILESH KOTHARI DC (CEO)
(678) 904-7564
Entity
Organization
Contact information
Practice address
315 BOULEVARD NE, SUITE 555, ATLANTA, GA 30312-1200
(678) 904-7564
Mailing address
3060 PEACHTREE RD NW, SUITE 965, ATLANTA, GA 30305-2234
(678) 904-7564
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
033801
GA
Other
Enumeration date
03/09/2015
Last updated
03/09/2015
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