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General NPI Number Information
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NPI Number | 1497615769
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Entity Type | Organization
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Legal Business Name | CALIFORNIA COAST CARDIOVASCULAR, PC
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Dates
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Enumeration Date | 11/17/2025
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 4060 FOURTH AVE STE 500
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City | SAN DIEGO
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State | CA
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Zip | 92103-2121
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Country | US
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Telephone | 310-897-6940
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Fax |
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Provider Business Mailing Address
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Address Line | 4060 FOURTH AVE
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City | SAN DIEGO
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State | CA
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Zip | 92103-2116
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Country | US
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Telephone | 619-260-1900
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICOLE HERRICK
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Credential | MD
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Telephone | 310-897-6940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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