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General NPI Number Information
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NPI Number | 1093853608
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Entity Type | Organization
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Legal Business Name | COASTAL OCCUPATIONAL MEDICAL GROUP, INC
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Dates
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Enumeration Date | 02/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1901 OUTLET CENTER DR SUITE 100
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City | OXNARD
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State | CA
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Zip | 93036-0663
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Country | US
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Telephone | 805-988-3200
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Fax | 805-988-3707
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Provider Business Mailing Address
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Address Line | 1901 OUTLET CENTER DR SUITE 100
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City | OXNARD
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State | CA
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Zip | 93036-0663
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Country | US
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Telephone | 805-988-3200
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Fax | 805-988-3707
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MICHAEL BYER
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Credential | M.D
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Telephone | 805-988-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | CA
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