Coastal Village Primary, INC
NPI #1396080511 in Pismo Beach, California
Provider Information
- NPI Number
- 1396080511
- Entity Type
- Organization
- Organization Name
- Coastal Village Primary, INC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Nov 28, 2012
- Last Updated
- Nov 28, 2012
Practice Location
- Address
- 2 JAMES WAY
- Address 2
- SUITE 209
- City
- Pismo Beach
- State
- California
- ZIP Code
- 93449-4973
- Phone
- (805) 773-7440
Authorized Official
- Name
- DR. JOSEPH A CRUZ, MD
- Title
- PRESIDENT/OWNER
- Phone
- (805) 773-7440
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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