Coastal Community Center INC

NPI #1295690527 in Provo, Utah

Provider Information

NPI Number
1295690527
Entity Type
Organization
Organization Name
Coastal Community Center INC
Primary Specialty
Nurse Practitioner - Primary Care
Enumeration Date
Dec 18, 2025
Last Updated
Dec 18, 2025

Practice Location

Address
3650 N UNIVERSITY AVE STE 150
City
Provo
State
Utah
ZIP Code
84604-6636
Phone
(702) 809-2505

Authorized Official

Name
AYUSHMAAN SRINIVASA
Title
BOARD MEMBER
Phone
(702) 809-2505

Specialties & Taxonomy Codes

Specialty
Internal Medicine
Nurse Practitioner - Primary CarePrimary Care

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