California Coastal Medical PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

G86429 Issued in CA

Legal business name

CALIFORNIA COASTAL MEDICAL PC

Practice address

301 Yamato Rd
Suite 1100
Boca Raton, FL 33431-4917

Phone

(855) 200-8262

Fax

(855) 400-8262

NPI assigned

Jul 8, 2014

Last updated

Jul 8, 2014By 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. Andrew Joseph McDonnell, MD

Title

President

Phone

(855) 200-8262

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404777600000",
    "number": "1831505155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 YAMATO RD",
            "address_2": "SUITE 1100",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314917",
            "telephone_number": "855-200-8262",
            "fax_number": "855-400-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 YAMATO RD",
            "address_2": "SUITE 1100",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314917",
            "telephone_number": "855-200-8262",
            "fax_number": "855-400-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA COASTAL MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-08",
        "last_updated": "2014-07-08",
        "status": "A",
        "authorized_official_last_name": "MCDONNELL",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "855-200-8262",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G86429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2014; 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.