| Coastal Vascular Medicine Inc | |
|
320 Superior Ave Ste 250 Newport Beach CA 92663-2778 | |
| (949) 631-6002 | |
| (949) 631-6982 |
| Full Name | Coastal Vascular Medicine Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 320 Superior Ave Ste 250, Newport Beach, California |
| Authorized Official Name and Position | Ehab Nabil Hanna Mady (OWNER) |
| Authorized Official Contact | 9496316002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Vascular Medicine Inc 320 Superior Ave Ste 250 Newport Beach CA 92663-2778 Ph: (949) 631-6002 | Coastal Vascular Medicine Inc 320 Superior Ave Ste 250 Newport Beach CA 92663-2778 Ph: (949) 631-6002 |
| NPI Number | 1104234194 |
|---|---|
| Provider Enumeration Date | 07/23/2014 |
| Last Update Date | 02/20/2025 |
| Medicare PECOS PAC ID | 9830317783 |
|---|---|
| Medicare Enrollment ID | O20140905001954 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104234194 | NPI | - | NPPES |
| Provider Name | Ehab N Mady |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265600795 PECOS PAC ID: 6608938428 Enrollment ID: I20090102000234 |
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