NPIMap

Organization Active NPI

Coast Surgical Group, a Medical Corporation

Doing business as Coast Surgical Group, AMC

  • Specialist
  • Chula Vista, CA
National Provider Identifier
1184723629
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
COAST SURGICAL GROUP, A MEDICAL CORPORATION
Doing business as
Coast Surgical Group, AMC
Practice address
786 3Rd Ave
Suite B
Chula Vista, CA 91910-5826
Phone
(619) 425-0797
Fax
(619) 425-0596
NPI assigned
Sep 21, 2006
Last updated
Apr 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

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

Authorized official

Name
Dr. Francisco Antonio Hernandez, M.D.NPI 1114907706
Title
President
Phone
(619) 425-0797

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X CA Primary

Addresses

Primary practice location

786 3Rd Ave
Suite B
Chula Vista, CA 91910-5826

Mailing address

786 3Rd Ave
Suite B
Chula Vista, CA 91910-5826
Phone (619) 425-0797

Other identifiers 1

IdentifierTypeStateIssuer
GR0062500MedicaidCA

Other names 1

  • COAST SURGICAL GROUP, AMC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040915001124 CA Part B Supplier - Clinic/Group Practice 2163499385 Receives reassigned benefits from 9 practitioners
Practice locations: Chula Vista, CA

National Provider Directory

National Provider Directory

Locations

786 Third Ave
Ste B
Chula Vista, CA 91910
Phone (619) 425-0797

855 Third Ave
Ste 3340
Chula Vista, CA 91911
Phone (619) 425-0797

230 Prospect Pl
#340
Coronado, CA 92118
Phone (619) 425-0797

Practitioners & affiliated clinicians

Practitioners 9

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": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428364800000",
    "number": "1184723629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "786 3RD AVE",
            "address_2": "SUITE B",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919105826",
            "telephone_number": "619-425-0797",
            "fax_number": "619-425-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "786 3RD AVE",
            "address_2": "SUITE B",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919105826",
            "telephone_number": "619-425-0797",
            "fax_number": "619-425-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAST SURGICAL GROUP, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2015-04-07",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "FRANCISCO",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-425-0797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0062500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COAST SURGICAL GROUP, AMC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.