NPIMap

Organization Active NPI

Coastline Medical Clinic Inc

  • Pain Medicine Physician
  • Westminster, CA
National Provider Identifier
1013218007
Registry record updated Dec 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
COASTLINE MEDICAL CLINIC INC
Practice address
15606 Brookhurst St
Ste a
Westminster, CA 92683-7581
Phone
(714) 531-7730
Fax
(714) 531-7793
NPI assigned
Nov 8, 2010
Last updated
Dec 29, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Phong H Tran, MDNPI 1184609885
Title
President
Phone
(714) 531-7730

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

15606 Brookhurst St
Ste a
Westminster, CA 92683-7581

Mailing address

PO Box 9658
Fountain Valley, CA 92728-9658
Phone (714) 531-7730

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ECEIBA

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419811200000",
    "number": "1013218007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9658",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927289658",
            "telephone_number": "714-531-7730",
            "fax_number": "714-531-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15606 BROOKHURST ST",
            "address_2": "STE A",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926837581",
            "telephone_number": "714-531-7730",
            "fax_number": "714-531-7793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTLINE MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-08",
        "last_updated": "2014-12-29",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "PHONG",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-531-7730",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.