Provider Demographics
NPI:1487543690
Name:PACIFIC COAST DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS
Entity type:Organization
Organization Name:PACIFIC COAST DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:833-328-4523
Mailing Address - Street 1:18 BATES BLVD
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-2804
Mailing Address - Country:US
Mailing Address - Phone:833-328-4523
Mailing Address - Fax:831-603-6769
Practice Address - Street 1:1900 GARDEN RD STE 200
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5334
Practice Address - Country:US
Practice Address - Phone:833-328-4523
Practice Address - Fax:831-603-6769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral PediatricsGroup - Single Specialty