Active NPI
Cosa San Diego
- Supports Brokerage Agency
- Imperial Beach, CA
National Provider Identifier
1982511242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Supports Brokerage Agency
- Legal business name
- COSA SAN DIEGO
- Practice address
- 1112 Seacoast Dr Apt 11
Imperial Beach, CA 91932-3131 - Phone
- (503) 318-5438
- NPI assigned
- Aug 24, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Thomas Cornwell
- Title
- Director of Operations
- Phone
- (619) 871-4924
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | |||
| Community/Behavioral Health Agency | 251S00000X | |||
| Supports Brokerage Agency | 251X00000X | Primary |
Addresses
Primary practice location
1112 Seacoast Dr Apt 11
Imperial Beach, CA 91932-3131
Mailing address
1112 Seacoast Dr Apt 9
Imperial Beach, CA 91932-3131
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787529600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788393600000",
"number": "1982511242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1112 SEACOAST DR APT 9",
"city": "IMPERIAL BEACH",
"state": "CA",
"postal_code": "919323131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1112 SEACOAST DR APT 11",
"city": "IMPERIAL BEACH",
"state": "CA",
"postal_code": "919323131",
"telephone_number": "503-318-5438"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COSA SAN DIEGO",
"organizational_subpart": "NO",
"enumeration_date": "2026-08-24",
"last_updated": "2026-09-03",
"certification_date": "2026-09-03",
"status": "A",
"authorized_official_last_name": "CORNWELL",
"authorized_official_first_name": "THOMAS",
"authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
"authorized_official_telephone_number": "619-871-4924",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "251X00000X",
"taxonomy_group": "",
"desc": "Supports Brokerage",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Imperial Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.