Coastal Health Alliance

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

110000413 Issued in CA

Legal business name

COASTAL HEALTH ALLIANCE

Doing business as

Stinson Beach Medical Center

Practice address

3419 State Route One
Stinson Beach, CA 94970-0978

Phone

(415) 868-9656

Fax

(415) 868-2858

NPI assigned

Aug 30, 2006

Last updated

Apr 7, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Severson

Title

Executive Director

Phone

(415) 663-8781

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Stinson Beach Medical Center Doing business as

Practitioners 2

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.

• Anna Kristina O'Malley, M.D.

  • Family Medicine Physician
  • Stinson Beach, CA
  • NPI 1447459185
  NPD (past)
• Kimberly Allison Young, MD

  • Family Medicine Physician
  • Stinson Beach, CA
  • NPI 1114000973
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207526400000",
    "number": "1255441358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 910",
            "city": "POINT REYES STATION",
            "state": "CA",
            "postal_code": "949560910",
            "telephone_number": "415-663-8781",
            "fax_number": "415-663-9632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 STATE ROUTE ONE",
            "city": "STINSON BEACH",
            "state": "CA",
            "postal_code": "949700978",
            "telephone_number": "415-868-9656",
            "fax_number": "415-868-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL HEALTH ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-04-07",
        "status": "A",
        "authorized_official_last_name": "SEVERSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "415-663-8781"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "110000413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC53833F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stinson Beach Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Martin J Cline, M.D.
• Kenneth Scott Kandler, D.C.
• Karen Elaine Mercola, MD
• Anna Kristina O'Malley, M.D.
• Sitka Medical Associates PC
• Stinson Beach Fire Protection District

• Federally Qualified Health Center (FQHC) in Stinson Beach, CA
• Providers in Stinson Beach, CA by specialty
• Federally Qualified Health Center (FQHC) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; 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.