Provider Demographics
NPI:1356356794
Name:CALIFORNIA COAST CARE, INC.
Entity type:Organization
Organization Name:CALIFORNIA COAST CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKOULINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-395-0795
Mailing Address - Street 1:44 LESSAY
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92657-1060
Mailing Address - Country:US
Mailing Address - Phone:949-395-0795
Mailing Address - Fax:949-497-2020
Practice Address - Street 1:999 N TUSTIN AVE
Practice Address - Street 2:SUITE 17
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3528
Practice Address - Country:US
Practice Address - Phone:949-395-0795
Practice Address - Fax:949-497-2020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic