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General NPI Number Information
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NPI Number | 1750264685
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Entity Type | Organization
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Legal Business Name | COASTLINE ENDOCRINOLOGY ASSOCIATES, P.C.
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Dates
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Enumeration Date | 07/29/2025
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 25381 COMMERCENTRE DR
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City | LAKE FOREST
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State | CA
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Zip | 92630-8860
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Country | US
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Telephone | 714-566-4022
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Fax |
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Provider Business Mailing Address
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Address Line | 2326 REDWOOD DR
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City | TUSTIN
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State | CA
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Zip | 92782-8371
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Country | US
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Telephone | 714-566-4022
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRADLEY SEAN NEUTEL
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Credential | MD
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Telephone | 714-566-4022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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