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NPI Code Detail

MEDICARE: COAST PAIN MANAGEMENT MEDICAL GROUP, INC.

MEDICARE: COAST PAIN MANAGEMENT MEDICAL GROUP, INC.
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
1208VP0014XInterventional Pain Medicine PhysicianG73289CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11639199045OTHERCANPI

General Provider Information

NPI Number : 1821267733
Entity Type Code : Organization
Provider Name (Legal Business Name) : COAST PAIN MANAGEMENT MEDICAL GROUP, INC.
Provider Business Mailing Address
First Line : PO BOX 27298
Second Line :
City : SANTA ANA
State : CA
Zip : 92799-7298
Country : US
Telephone Number : 714-495-4050
Fax Number : 714-497-1485
Provider Business Practice Location Address
First Line : 1950 EAST 17TH STREET
Second Line : SUITE #200
City : SANTA ANA
State : CA
Zip : 92705-6852
Country : US
Telephone Number : 714-495-4050
Fax Number : 714-497-1485
Authorized Official
Title or Position : OWNER
Name : DR. CLIFFORD ALEXANDER BERNSTEIN
Credential : M.D.
Telephone Number : 714-495-4050
Provider Enumeration Date : 02/25/2008
Last Update Date : 04/11/2019

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Directions to “COAST PAIN MANAGEMENT MEDICAL GROUP, INC. ” Practice Location

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