Organization
COASTAL KIDS, A PROFESSIONAL MEDICAL CORPORATION
Active
Other names
Coastal Kids, Coastal Kids, A Professional Medical Corporation
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY THOMPSON (VICE PRESIDENT)
(949) 448-8821
Entity
Organization
Contact information
Practice address
2071 SAN JOAQUIN HILLS RD, NEWPORT BEACH, CA 92660-6505
(949) 759-1720
(949) 759-1442
Mailing address
24422 AVENIDA DE LA CARLOTA STE 300, LAGUNA HILLS, CA 92653-3628
(949) 599-2434
(949) 599-2430
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A56395
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A563950
—
CA
Enumeration date
03/08/2007
Last updated
11/17/2023
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