Organization
COASTLINE MED MANAGEMENT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUBEN HERNANDEZ (PRESIDENT)
(714) 515-5607
Entity
Organization
Contact information
Practice address
300 S HARBOR BLVD, #920, ANAHEIM, CA 92805-3733
(714) 515-5607
Mailing address
300 S HARBOR BLVD, #920, ANAHEIM, CA 92805-3733
(714) 515-5607
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
12/20/2013
Last updated
12/20/2013
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