Coastal Physicians Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

COASTAL PHYSICIANS MEDICAL GROUP

Practice address

824 E Carson St Ste 101
Carson, CA 90745-2262

Phone

(310) 233-3202

Fax

(310) 233-3208

NPI assigned

Nov 14, 2007

Last updated

Nov 15, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Luis G Magdaleno, M.D.NPI 1164492013

Title

Ceo

Phone

(310) 832-4225

Specialties & licenses 1

Addresses

Other names 1

• Coastal Physicians Medical Group Former legal business name

Tax ID family

Coastal Physicians Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Coastal Physicians Medical Group-RPV

  • Family Medicine Physician
  • Rancho Palos Verdes, CA
  • NPI 1821279183
  NPD tax ID

Practitioners 1

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.

• Luis G Magdaleno, MD

  • Family Medicine Physician
  • San Pedro, CA
  • NPI 1164492013
  Authorized official Same address or phone

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1588845978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 E CARSON ST STE 101",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907452262",
            "telephone_number": "310-233-3202",
            "fax_number": "310-233-3208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 E CARSON ST STE 101",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907452262",
            "telephone_number": "310-233-3202",
            "fax_number": "310-233-3208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PHYSICIANS MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "MAGDALENO",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-832-4225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Physicians Medical Group",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Romana Colin
• Tommy Edward Collins III
• Community Dental Services (SmileCare Dental Group)
• Gloria B Cordero, DMD

• Family Medicine Physician in Carson, CA
• Providers in Carson, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.