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General NPI Number Information
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NPI Number | 1356356794
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Entity Type | Organization
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Legal Business Name | CALIFORNIA COAST CARE, INC.
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 999 N TUSTIN AVE SUITE 17
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City | SANTA ANA
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State | CA
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Zip | 92705-3528
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Country | US
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Telephone | 949-395-0795
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Fax | 949-497-2020
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Provider Business Mailing Address
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Address Line | 44 LESSAY
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City | NEWPORT BEACH
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State | CA
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Zip | 92657-1060
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Country | US
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Telephone | 949-395-0795
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Fax | 949-497-2020
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. NATALIA BAKOULINA
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Credential |
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Telephone | 949-395-0795
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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