Organization
COASTAL SURGICAL SPECIALISTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN ANDERSEN (CHIEF FINANCIAL OFFICER)
(805) 739-3110
Entity
Organization
Contact information
Practice address
921 OAK PARK BLVD, 101, PISMO BEACH, CA 93449-3264
(805) 473-9850
(805) 473-9851
Mailing address
921 OAK PARK BLVD, 101, PISMO BEACH, CA 93449-3264
(805) 473-9850
(805) 473-9851
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
050000593
CA
Other
Enumeration date
09/16/2006
Last updated
06/18/2014
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