Provider Demographics
NPI:1528860459
Name:COASTAL IMAGING AND INTERVENTION INC
Entity type:Organization
Organization Name:COASTAL IMAGING AND INTERVENTION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REZA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHBAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-999-6000
Mailing Address - Street 1:PO BOX 60049
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91066-6049
Mailing Address - Country:US
Mailing Address - Phone:626-698-7246
Mailing Address - Fax:
Practice Address - Street 1:1111 W LA PALMA AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2804
Practice Address - Country:US
Practice Address - Phone:714-999-3847
Practice Address - Fax:714-999-6127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty