Coastal Mesa Corp.

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

COASTAL MESA CORP.

Practice address

777 W 19TH St Ste J
Costa Mesa, CA 92627-6131

Phone

(657) 203-2133

NPI assigned

Jul 1, 2020

Organization subpart

No

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

Authorized official

Name

Alex Sadak

Title

Manager

Phone

(657) 203-2133

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593561600000",
    "number": "1104443506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 W 19TH ST STE J",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926276131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 W 19TH ST STE J",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926276131",
            "telephone_number": "657-203-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL MESA CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-01",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A",
        "authorized_official_last_name": "SADAK",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "657-203-2133"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Christine Wambui Coats, BS
• Reynaldo Cobarrubia
• Jacob Cochran
• Ana A Codiz Medina

• Multi-Specialty Clinic/Center in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.