Coastal Pathology Medical Associates, Inc

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

COASTAL PATHOLOGY MEDICAL ASSOCIATES, INC

Practice address

2425 Harrison Ave
Eureka, CA 95501-3218

Phone

(707) 441-4420

Fax

(707) 269-3889

NPI assigned

Jul 5, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Stanley T Hino, M.D.

Title

President

Phone

(707) 441-4420

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455667200000",
    "number": "1528065679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 HARRISON AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013218",
            "telephone_number": "707-445-8121",
            "fax_number": "707-269-3782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 HARRISON AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013218",
            "telephone_number": "707-441-4420",
            "fax_number": "707-269-3889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PATHOLOGY MEDICAL ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-05",
        "last_updated": "2016-02-17",
        "status": "A",
        "authorized_official_last_name": "HINO",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-441-4420",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4779028",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wanda Jo Cloud, CAS
• Jessica Nichole Clower
• Carol Lee Coal, LCSW
• Julie Coar
• Coastal Orthotic and Prosthetic Services, Inc
• Jessica C Coats
• Randolph Coats, LMFT
• Luther F Cobb, M.D.
• Terry L Coddington, CATC
• Christopher Lee Cody, MD

• Anatomic Pathology & Clinical Pathology Physician in Eureka, CA
• Providers in Eureka, CA by specialty
• Anatomic Pathology & Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.