Coastline Hospice Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

COASTLINE HOSPICE INC

Practice address

2777 Pacific Ave Ste L
Long Beach, CA 90806-2625

Phone

(562) 317-8778

Fax

(562) 317-8779

NPI assigned

Oct 8, 2020

Organization subpart

No

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

Authorized official

Name

Jessica Dashtoyan

Title

Ceo

Phone

(562) 317-8778

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospice certification: CCN B51673

Legal name

COASTLINE HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Mar 21, 2023

Last certification

Mar 21, 2023

Organization structure

CorporationProprietary

Incorporated

Jun 23, 2020 in CA

Enrollment address

7630 Vineland Ave
Ste 207a
Sun Valley, CA 91352-4535

Listed as

Coastline Hospice, IncCCN B51673 · All quality measures

Certified

Mar 21, 2023

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Benjamin Behroozan, M.D.

  • Family Medicine Physician
  • Santa Monica, CA
  • NPI 1750440681
  NPD

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Rame D Iberdemaj, MD

  • Surgery Physician
  • Madera, CA
  • NPI 1922294453

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607558400000",
    "number": "1336746684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2777 PACIFIC AVE STE L",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062625",
            "telephone_number": "562-317-8778",
            "fax_number": "562-317-8779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2777 PACIFIC AVE STE L",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062625",
            "telephone_number": "562-317-8778",
            "fax_number": "562-317-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTLINE HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A",
        "authorized_official_last_name": "DASHTOYAN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-317-8778"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Coastal Children's Specialty Group, Inc.
• Coastal Community Senior Care, LLC (Home Instead Senior Care)
• Coastal Nurse Anesthesia, Inc.
• Coastline Physical Therapy, Inc
• Jennifer Rae Coates, LVN
• Stephen Anthony Coates, D.D.S.
• Allyson Coats
• Maren Kussler Cobabe, L.AC.

• Community Based Hospice Care Agency in Long Beach, CA
• Providers in Long 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 Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.