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General NPI Number Information
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NPI Number | 1366392987
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Entity Type | Organization
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Legal Business Name | COASTAL CONCIERGE MEDICAL PRACTIONERS, INC
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Dates
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Enumeration Date | 02/02/2026
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 620 CALIFORNIA BLVD STE R
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-2586
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Country | US
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Telephone | 805-439-4972
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Fax | 805-439-4976
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Provider Business Mailing Address
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Address Line | 620 CALIFORNIA BLVD STE R
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-2586
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Country | US
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Telephone | 805-439-4972
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Fax | 805-439-4976
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Authorized Official
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Title or Position | CEO
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Name | SCOTT A MOREY JR.
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Credential | MD
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Telephone | 805-439-4972
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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