Provider Demographics
NPI:1427473917
Name:COAST PCP, PLLC
Entity type:Organization
Organization Name:COAST PCP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AZAD
Authorized Official - Middle Name:ALAMGIR
Authorized Official - Last Name:KABIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:228-202-7872
Mailing Address - Street 1:1120 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39530-3631
Mailing Address - Country:US
Mailing Address - Phone:228-202-7872
Mailing Address - Fax:228-202-7871
Practice Address - Street 1:1120 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39530-3631
Practice Address - Country:US
Practice Address - Phone:228-342-6278
Practice Address - Fax:228-202-7871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-20
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty