Coastal Podiatry Clinic

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

E4306 Issued in CA

Legal business name

COASTAL PODIATRY CLINIC

Practice address

2 James Way
Suite 205
Pismo Beach, CA 93449-4973

Phone

(805) 773-3668

Fax

(805) 773-1043

NPI assigned

Mar 3, 2008

Organization subpart

Yes

Parent organization

RICHARD NORMANAs reported in NPPES

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

Authorized official

Name

Richard Jay Norman, DPM

Title

Sole Proprietor

Phone

(805) 773-3668

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Coastal Podiatry Clinic Doing business as
• RICHARD J NORMAN DPM Doing business as

Part of

Richard Norman

Locations

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561075200000",
    "number": "1336319698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 JAMES WAY",
            "address_2": "SUITE 205",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934494973",
            "telephone_number": "805-773-3668",
            "fax_number": "805-773-1043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 JAMES WAY",
            "address_2": "SUITE 205",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934494973",
            "telephone_number": "805-773-3668",
            "fax_number": "805-773-1043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PODIATRY CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RICHARD NORMAN",
        "enumeration_date": "2008-03-03",
        "last_updated": "2019-06-21",
        "status": "A",
        "authorized_official_last_name": "NORMAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "805-773-3668",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CA",
            "license": "E4306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PODIATRIC MEDICINE LICENSE",
            "identifier": "E4306",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Podiatry Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RICHARD J NORMAN DPM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanthi Chandrasena, M.D.
• Kenna Chapin
• Janet Chen, M.D,
• David G. Christensen, M.D.
• Christopher V Lutman MD a California Medical Corporation
• Coastal Podiatry Inc
• Coastal Psychiatry Care Professional Nursing Corp
• Coastal Surgical Specialists, Inc.
• Coastal Village Primary Care
• Coastal Village Primary Care, a Medical Group

• Foot Surgery Podiatrist in Pismo Beach, CA
• Providers in Pismo Beach, CA by specialty
• Foot Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; 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.