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Organization

COASTAL HEALTH LASER AESTHETICS

Active
Other names
A NU ME
Organization subpart
No

Provider details

NPI number
Authorized official
DEBRA LYNN SANDERSON (OPERATION MANAGER)
(805) 644-4809
Entity
Organization

Contact information

Practice address
501 W CHANNEL ISLANDS BLVD, SUITE 302, PORT HUENEME, CA 93041-2126
(805) 815-4400
(805) 815-4848
Mailing address
501 W CHANNEL ISLANDS BLVD, SUITE 302, PORT HUENEME, CA 93041-2126
(805) 815-4400
(805) 815-4848

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A26431
CA

Other

Enumeration date
03/25/2008
Last updated
03/25/2008
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