MEDICARE: PACIFIC COAST OSTEOPATHY

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
1	207Q00000X	Family Medicine Physician	20A9974	CA

General Provider Information

NPI Number	:	1235477498
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACIFIC COAST OSTEOPATHY

Provider Business Mailing Address
First Line	:	550 SILVER SPUR RD STE 240
Second Line	:
City	:	ROLLING HILLS ESTATES
State	:	CA
Zip	:	90275-3612
Country	:	US
Telephone Number	:	310-792-8900
Fax Number	:	310-792-8907

Provider Business Practice Location Address
First Line	:	550 SILVER SPUR RD STE 240
Second Line	:
City	:	ROLLING HILLS ESTATES
State	:	CA
Zip	:	90275-3612
Country	:	US
Telephone Number	:	310-792-8900
Fax Number	:	310-792-8907

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	DR. TINA ASHRAFZADEH
Credential	:	DO
Telephone Number	:	310-792-8900

Provider Enumeration Date	:	01/23/2013
Last Update Date	:	11/05/2021

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Practice Location Address:

550 SILVER SPUR RD STE 240
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Directions to “PACIFIC COAST OSTEOPATHY ” Practice Location

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