MEDICARE: DG COAST MEDICAL INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1366128050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DG COAST MEDICAL INC

Provider Business Mailing Address
First Line	:	9121 ATLANTA AVE STE 723
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92646-6309
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17312 NORCON CIR
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-4613
Country	:	US
Telephone Number	:	714-912-6714
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	TYLER GOSSETT
Credential	:
Telephone Number	:	714-912-6714

Provider Enumeration Date	:	06/26/2023
Last Update Date	:	06/26/2023

Similar Medicare Providers

1407025554 — JENNIFER KLEIN
Practice Location Address:

602 7TH ST
HUNTINGTON BEACH, CA
92648-4613

Practice Phone: 310-463-5236
Practice Fax:

1750432399 — MR. JAMES DECICCO OPTICIAN
Practice Location Address:

699A OLD COUNTRY RD
HUNTINGTON STATION, NY
11746-4613

Practice Phone: 631-271-3520
Practice Fax: 631-271-3706

1447404587 — SUNSHINE OPTICAL, INC.
Practice Location Address:

699A OLD COUNTRY RD
HUNTINGTON STATION, NY
11746-4613

Practice Phone: 631-271-3520
Practice Fax: 631-271-3706

1801681929 — ROBERT J BEAULIEU
Practice Location Address:

270 HUNTINGTON AVE APT 304
BOSTON, MA
02115-4613

Practice Phone: 617-791-4993
Practice Fax:

1841263464 — PALM BEACH AQUATICS & PHYSICAL THERAPY INC
Practice Location Address:

3111 W BOYNTON BEACH BLVD , SUITE 200
BOYNTON BEACH, FL
33436-4613

Practice Phone: 561-742-3283
Practice Fax: 561-742-3280

1215117502 — ALAN D CHRONISTER RPH
Practice Location Address:

4613 BRADSTON RD
VIRGINIA BEACH, VA
23455-4311

Practice Phone: 817-781-4221
Practice Fax:

Directions to “DG COAST MEDICAL INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.