Coastal Functional Medicine

Organization Active NPI Family Medicine Physician · Fort Bragg, CA

NPI 1487328951 · NPPES record last updated Aug 6, 2021

Key facts

NPI
1487328951
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
COASTAL FUNCTIONAL MEDICINE
Practice address
17800 Freitas LN
Fort Bragg, CA 95437-8329
Phone
(707) 440-9898
NPI assigned
Aug 6, 2021
Organization subpart
No

Authorized official

Name
Dr. Sandra Fleming, MD
Title
Ceo
Phone
(707) 440-9898

Practitioners 1

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

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

17800 Freitas LN
Fort Bragg, CA 95437-8329

Mailing address

17800 Freitas LN
Fort Bragg, CA 95437-8329
Phone (707) 440-9898

Other providers in Fort Bragg, CA

All providers in Fort Bragg, CA · Family Medicine Physician in California

Sources for this page

Verify at the official NPI Registry.