NPIMap

Organization Active NPI

Coastal Wellness Medical Group, Inc

  • Clinic/Center
  • Templeton, CA
National Provider Identifier
1578738324
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
20A7376 Issued in CA
Legal business name
COASTAL WELLNESS MEDICAL GROUP, INC
Practice address
292 Posada LN
Suite a
Templeton, CA 93465-4054
Phone
(805) 434-5222
NPI assigned
Apr 23, 2008
Last updated
Apr 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Authorized official

Name
Dr. Christopher T Bradburn, D.O
Title
President
Phone
(805) 434-5222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 20A7376 CA Primary

Addresses

Primary practice location

292 Posada LN
Suite a
Templeton, CA 93465-4054

Mailing address

1310 Las Tablas Rd
Suite 207
Templeton, CA 93465-9737
Phone (805) 369-1305

National Provider Directory

National Provider Directory

Locations

1310 Las Tablas Rd
Ste 207
Templeton, CA 93465

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1578738324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 LAS TABLAS RD",
            "address_2": "SUITE 207",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934659737",
            "telephone_number": "805-369-1305",
            "fax_number": "805-369-1309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 POSADA LN",
            "address_2": "SUITE A",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934654054",
            "telephone_number": "805-434-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL WELLNESS MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-23",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "BRADBURN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-434-5222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "20A7376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Templeton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.