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General NPI Number Information
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NPI Number | 1487543690
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Entity Type | Organization
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Legal Business Name | PACIFIC COAST DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 1900 GARDEN RD STE 200
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City | MONTEREY
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State | CA
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Zip | 93940-5334
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Country | US
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Telephone | 833-328-4523
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Fax | 831-603-6769
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Provider Business Mailing Address
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Address Line | 18 BATES BLVD
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City | ORINDA
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State | CA
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Zip | 94563-2804
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Country | US
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Telephone | 833-328-4523
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Fax | 831-603-6769
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MARY COLEMAN
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Credential | MD, MPH
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Telephone | 833-328-4523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number |
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License Number State |
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