Healthcare Provider Details

I. General information

NPI: 1982919064
Provider Name (Legal Business Name): WEST COAST HOSPITALISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2010
Last Update Date: 08/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 MERCY AVE
MERCED CA
95340-8319
US

IV. Provider business mailing address

1 MCBRIDE AND SON CENTER DR SUITE 150
CHESTERFIELD MO
63005-1425
US

V. Phone/Fax

Practice location:
  • Phone: 636-530-0800
  • Fax:
Mailing address:
  • Phone: 636-530-0800
  • Fax: 636-534-5058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC43224
License Number StateCA

VIII. Authorized Official

Name: CHRISTOPHER KANG
Title or Position: OWNER
Credential: MD
Phone: 636-530-0800