Coastal Orthotic and Prosthetic Services, Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

COASTAL ORTHOTIC AND PROSTHETIC SERVICES, INC

Practice address

2365 Harrison Ave
Eureka, CA 95501-3216

Phone

(707) 445-3111

Fax

(707) 442-8792

NPI assigned

Nov 30, 2007

Organization subpart

No

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

Authorized official

Name

Alfred M Quintana, CPONPI 1255420774

Title

President

Phone

(707) 445-3111

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Alfred Micheal Quintana, CPO

  • Prosthetics Case Management
  • Eureka, CA
  • NPI 1255420774
  NPD (past) Authorized official
• Jean L Talleyrand, M.D.

  • General Practice Physician
  • San Francisco, CA
  • NPI 1689963456
  NPD (past)

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1457533531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2365 HARRISON AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013216",
            "telephone_number": "707-445-3111",
            "fax_number": "707-442-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 HARRISON AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013216",
            "telephone_number": "707-445-3111",
            "fax_number": "707-442-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL ORTHOTIC AND PROSTHETIC SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "QUINTANA",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-445-3111",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GXC000320",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick Eugene Cloney, PHARMD
• Wanda Jo Cloud, CAS
• Jessica Nichole Clower
• Carol Lee Coal, LCSW
• Julie Coar
• Coastal Pathology Medical Associates, Inc
• Jessica C Coats
• Randolph Coats, LMFT
• Luther F Cobb, M.D.
• Terry L Coddington, CATC

• Prosthetic/Orthotic Supplier in Eureka, CA
• Providers in Eureka, CA by specialty
• Prosthetic/Orthotic Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; 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.