Organization
COASTAL HEART, INC
Active
Organization
COASTAL HEART, INC
Active
Other names
Coastal Heart Inc, Coastal Heart Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
REBECA E HERNANDEZ (ADMINISTRATOR)
(714) 754-1684
Entity
Organization
Contact information
Practice address
2621 S BRISTOL ST STE 108, SANTA ANA, CA 92704-5718
(714) 754-1684
(714) 966-0417
Mailing address
2621 S BRISTOL ST, SUITE 108, SANTA ANA, CA 92704-5718
(714) 754-1684
(714) 966-0417
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0093900
—
CA
Enumeration date
07/17/2006
Last updated
05/19/2020
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