Provider Demographics
NPI:1154128544
Name:WEST COAST PRIMARY CARE & PSYCHIATRY SERVICES LLC
Entity type:Organization
Organization Name:WEST COAST PRIMARY CARE & PSYCHIATRY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ISMAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-506-5259
Mailing Address - Street 1:120 CALLE GRUBBS
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-1502
Mailing Address - Country:US
Mailing Address - Phone:787-506-5259
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA AGUSTIN RAMOS CALER INT
Practice Address - Street 2:CARRETERA 112 KM 1.4, SUITE 9
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:939-366-3652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty