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General NPI Number Information
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NPI Number | 1578486338
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Entity Type | Organization
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Legal Business Name | COASTAL CONCIERGE PHYSICIANS
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Dates
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Enumeration Date | 07/30/2026
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | 917 A AVE
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City | CORONADO
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State | CA
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Zip | 92118-2628
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Country | US
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Telephone | 619-675-9502
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Fax | 619-566-4943
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Provider Business Mailing Address
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Address Line | 917 A AVE
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City | CORONADO
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State | CA
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Zip | 92118-2628
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Country | US
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Telephone | 619-675-9502
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Fax | 619-566-4943
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL HOLMAN
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Credential | MD
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Telephone | 619-762-4991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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