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General NPI Number Information
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NPI Number | 1497013627
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Entity Type | Organization
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Legal Business Name | COAST PEDIATRICS DEL MAR
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Dates
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Enumeration Date | 04/25/2012
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Last Update Date | 05/09/2012
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Provider Practice Location Address
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Address Line | 12845 POINTE DEL MAR WAY
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City | DEL MAR
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State | CA
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Zip | 92014-3862
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Country | US
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Telephone | 858-794-7337
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Fax | 858-777-5492
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Provider Business Mailing Address
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Address Line | 12845 POINTE DEL MAR WAY
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City | DEL MAR
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State | CA
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Zip | 92014-3862
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Country | US
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Telephone | 858-794-7337
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Fax | 858-777-5492
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Authorized Official
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Title or Position | PARTNER
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Name | DR. LORI BETH TAYLOR
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Credential | M.D.
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Telephone | 858-335-5043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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