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General NPI Number Information
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NPI Number | 1568350767
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Entity Type | Organization
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Legal Business Name | CROWN COAST PHARMACY LLC
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Dates
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Enumeration Date | 06/25/2025
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 171 C AVE STE A
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City | CORONADO
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State | CA
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Zip | 92118-1423
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Country | US
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Telephone | 760-960-2689
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Fax |
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Provider Business Mailing Address
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Address Line | 11322 PEPPERVIEW TER
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City | SAN DIEGO
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State | CA
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Zip | 92131-3769
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Country | US
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Telephone | 760-960-2689
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Fax |
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | DR. ARASH KOHAN
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Credential | PHARMD
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Telephone | 760-960-2689
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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