Coastal Radiology Services, Inc.

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

Legal business name

COASTAL RADIOLOGY SERVICES, INC.

Practice address

32332 Camino Capistrano
Suite 205
San Juan Capistrano, CA 92675-3701

Phone

(949) 429-7404

Fax

(949) 481-3209

NPI assigned

Jul 17, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Martin A. Canales

Title

President

Phone

(949) 429-7404

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Coastal Lab & Radiology Services Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Kan-Di-Ki, LLC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Las Vegas, NV
  • NPI 1811210289

  Member Of

  NPD member

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063439818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32332 CAMINO CAPISTRANO",
            "address_2": "SUITE 205",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926753701",
            "telephone_number": "949-429-7404",
            "fax_number": "949-481-3209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32332 CAMINO CAPISTRANO",
            "address_2": "SUITE 205",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926753701",
            "telephone_number": "949-429-7404",
            "fax_number": "949-481-3209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL RADIOLOGY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CANALES",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-429-7404",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XR062500F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Lab & Radiology Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Virla Beatrice Clark, C.R.N.A.
• Darlene Clesceri
• Regina Lea Cline, MFT
• Coastal Infusions LLC
• Coastal Mountain Youth Academy
• Emily Coe
• Joann Coker, FNP
• Mia Collica, M.S., MFTI
• Grant Collins, MSOM, LAC
• Kristie Compau

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.