Provider Demographics
NPI:1427140144
Name:COAST GASTROENTEROLOGY A MEDICAL GROUP INC
Entity type:Organization
Organization Name:COAST GASTROENTEROLOGY A MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:A
Authorized Official - Last Name:FRANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-680-6850
Mailing Address - Street 1:2501 PESQUERA DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-1226
Mailing Address - Country:US
Mailing Address - Phone:310-680-6850
Mailing Address - Fax:310-680-6855
Practice Address - Street 1:501 E HARDY ST
Practice Address - Street 2:SUITE 430
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301
Practice Address - Country:US
Practice Address - Phone:310-680-6850
Practice Address - Fax:310-680-6855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0027410Medicaid
CACO1240Medicare PIN
CAGR0027410Medicaid
CACP8018Medicare PIN