| Coastal Comprehensive Care Medical Center Inc | |
|
25226 Cabot Rd Laguna Hills CA 92630 | |
| (949) 707-0005 | |
| (949) 707-5371 |
| Full Name | Coastal Comprehensive Care Medical Center Inc |
|---|---|
| Speciality | Pediatrics |
| Location | 25226 Cabot Rd, Laguna Hills, California |
| Authorized Official Name and Position | Paul Finn Cassedy (MEDICAL DIRECTOR MD) |
| Authorized Official Contact | 9497070005 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Comprehensive Care Medical Center Inc 25226 Cabot Rd Laguna Hills CA 92630 Ph: (949) 707-0005 | Coastal Comprehensive Care Medical Center Inc 25226 Cabot Rd Laguna Hills CA 92630 Ph: (949) 707-0005 |
| NPI Number | 1073603924 |
|---|---|
| Provider Enumeration Date | 10/13/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1850325812 |
|---|---|
| Medicare Enrollment ID | O20120815000043 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073603924 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Primary |
| Provider Name | Paul Finn Cassedy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417159948 PECOS PAC ID: 7012941073 Enrollment ID: I20120816000010 |
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