Coastal Integrative Medicine

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

COASTAL INTEGRATIVE MEDICINE

Practice address

2400 Temple Hills Dr
Laguna Beach, CA 92651-2668

Phone

(949) 943-9068

NPI assigned

Jan 19, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Pourya Mirsaeid Mirsaeid Ghazi, MD

Title

President

Phone

(949) 943-9068

Specialties & licenses 1

Addresses

Other names 1

• COASTAL INTEGRATIVE HEALTH Former legal business name

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

{
    "created_epoch": "1579392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579392000000",
    "number": "1164052163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 TEMPLE HILLS DR",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926512668",
            "telephone_number": "949-943-9068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 TEMPLE HILLS DR",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926512668",
            "telephone_number": "949-943-9068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL INTEGRATIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-19",
        "last_updated": "2020-01-19",
        "certification_date": "2020-01-19",
        "status": "A",
        "authorized_official_last_name": "MIRSAEID GHAZI",
        "authorized_official_first_name": "POURYA",
        "authorized_official_middle_name": "MIRSAEID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-943-9068",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COASTAL INTEGRATIVE HEALTH",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kellee Rae Clougherty, M.D.
• Kristen Clute
• Coast Concierge Medicine Inc
• Coast to Coast Referral Center, Inc.
• Coastal Endocrinology Inc
• Michael T Coccia, MD
• McKenna Coffey, LCSW
• Jay A Cohen, M.D.
• Susan Debra Cohn, L.C.S.W.
• Alaina Rae Collazo, DDS

• Community Based Hospice Care Agency in Laguna Beach, CA
• Providers in Laguna Beach, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.