Coachcare Mso LLC

NPI #1124837828 in Hermosa Beach, California

Provider Information

NPI Number: 1124837828
Entity Type: Organization
Organization Name: Coachcare Mso LLC
Primary Specialty: Internal Medicine
Enumeration Date: Jan 6, 2025
Last Updated: Jan 6, 2025

Practice Location

Address: 1246 19TH ST
City: Hermosa Beach
State: California
ZIP Code: 90254-3308
Phone: (917) 324-9942

Authorized Official

Name: LISA LORELLA
Title: VP STRATEGY
Phone: (917) 336-1205

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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