Coastal Health Laser Aesthetics

Primary specialty

SpecialistTaxonomy code 174400000X

License

A26431 Issued in CA

Legal business name

COASTAL HEALTH LASER AESTHETICS

Practice address

501 W Channel Islands Blvd
Suite 302
Port Hueneme, CA 93041-2126

Phone

(805) 815-4400

Fax

(805) 815-4848

NPI assigned

Mar 25, 2008

Organization subpart

No

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

Authorized official

Name

Debra Lynn Sanderson

Title

Operation Manager

Phone

(805) 644-4809

Specialties & licenses 1

Addresses

Other names 1

• A NU ME Doing business as

Locations

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206403200000",
    "number": "1992977482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W CHANNEL ISLANDS BLVD",
            "address_2": "SUITE 302",
            "city": "PORT HUENEME",
            "state": "CA",
            "postal_code": "930412126",
            "telephone_number": "805-815-4400",
            "fax_number": "805-815-4848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W CHANNEL ISLANDS BLVD",
            "address_2": "SUITE 302",
            "city": "PORT HUENEME",
            "state": "CA",
            "postal_code": "930412126",
            "telephone_number": "805-815-4400",
            "fax_number": "805-815-4848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL HEALTH LASER AESTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-25",
        "last_updated": "2008-03-25",
        "status": "A",
        "authorized_official_last_name": "SANDERSON",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OPERATION MANAGER",
        "authorized_official_telephone_number": "805-644-4809"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A26431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A NU ME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dianna Castro
• Esther Chan, PHARMD
• Carla Marie Clark, PTA
• Steven Daniel Clement, DO
• Lashay C Clemons, REGISTERED NURSE
• Mike Cockrill, IDC
• Thomas A Colp, OD
• Community Memorial Health System
• Olga Gutierrez Core, PHARMACIST
• Andrew Correces, D.D.S.

• Specialist in Port Hueneme, CA
• Providers in Port Hueneme, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.