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NPI Code Detail

MEDICARE: ACUTE CARE MEDICAL COASTAL

MEDICARE: ACUTE CARE MEDICAL COASTAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003869090
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACUTE CARE MEDICAL COASTAL
Provider Business Mailing Address
First Line : PO BOX 5172602
Second Line :
City : LOS ANGELES
State : CA
Zip : 90051
Country : US
Telephone Number : 562-809-3564
Fax Number :
Provider Business Practice Location Address
First Line : 2701 S BRISTOL ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92704-6201
Country : US
Telephone Number : 714-754-5454
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : PETER G ANDERSON
Credential : MD
Telephone Number : 562-809-3564
Provider Enumeration Date : 05/18/2006
Last Update Date : 12/22/2014

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Directions to “ACUTE CARE MEDICAL COASTAL ” Practice Location

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