Healthcare Provider Details
I. General information
NPI: 1821878299
Provider Name (Legal Business Name): WEST COAST PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/03/2023
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
23905 CLINTON KEITH RD # 114-503
WILDOMAR CA
92595-7897
US
IV. Provider business mailing address
23905 CLINTON KEITH RD # 114-503
WILDOMAR CA
92595-7897
US
V. Phone/Fax
- Phone: 951-514-8824
- Fax:
- Phone: 951-514-8824
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 247000000X |
| Taxonomy | Health Information Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JULI
MARKHAM
Title or Position: OWNER
Credential:
Phone: 951-514-8824