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General NPI Number Information
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NPI Number | 1952257024
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Entity Type | Organization
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Legal Business Name | COASTAL PRIMARY CARE PHYSICIANS
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Dates
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Enumeration Date | 03/10/2026
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 250 EL CAMINO REAL STE 209
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City | TUSTIN
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State | CA
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Zip | 92780-3656
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Country | US
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Telephone | 714-533-1234
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Fax | 714-991-1782
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Provider Business Mailing Address
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Address Line | 3972 BARRANCA PKWY STE J135
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City | IRVINE
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State | CA
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Zip | 92606-1204
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Country | US
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Telephone | 714-533-1234
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Fax | 714-991-1782
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | NISHCHAL KUMAR
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Credential | MD
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Telephone | 714-533-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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