National Provider Identifier Database

COASTAL CARDIOLOGY A MEDICAL CORP
Cardiovascular Disease

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.


Contact Information

COASTAL CARDIOLOGY A MEDICAL CORP
345 S HALCYON RD
ARROYO GRANDE, CA93420
Phone: 805-782-8844
Fax:
Website:
Specialty Taxonomy Code
* Cardiovascular Disease 207RC0000X
Interventional Cardiology 207RI0011X
Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for COASTAL CARDIOLOGY A MEDICAL CORP

NPI Number 1619127693
Legal business name
LBN
COASTAL CARDIOLOGY A MEDICAL CORP
Authorized official MARISSA FAMULARO - (OPERATIONS MANAGER)
Entity Organization
Organization subpart No
Enumeration date 09/25/2008
Last updated 09/09/2025 - About 9 months ago
Sole proprietor1 Not specified
Identifiers
  • CA Medicaid: GR0068680
  • Other: CP1074 RR MEDICARE
  • CA Other: ZZZ24859Z BLUE SHIELD

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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