| Coachcare Mso Llc | |
|
1246 19th St Hermosa Beach CA 90254-3308 | |
| (917) 324-9942 | |
| Not Available |
| Full Name | Coachcare Mso Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1246 19th St, Hermosa Beach, California |
| Authorized Official Name and Position | Lisa Lorella (VP STRATEGY) |
| Authorized Official Contact | 9173361205 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coachcare Mso Llc 211 E 43rd St Fl 7250 New York NY 10017-4707 Ph: () - | Coachcare Mso Llc 1246 19th St Hermosa Beach CA 90254-3308 Ph: (917) 324-9942 |
| NPI Number | 1124837828 |
|---|---|
| Provider Enumeration Date | 01/06/2025 |
| Last Update Date | 01/06/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124837828 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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