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Contact Information

PACIFIC COAST MEDICAL GROUP COMPANY
315 BOULEVARD NE
SUITE 555
ATLANTA, GA30312-1200
 Phone: 678-904-7564
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Medicine

2083X0100X 84 Physician/Preventive Medicine
Indicates primary specialty

NPI Profile & details for PACIFIC COAST MEDICAL GROUP COMPANY

NPI Number 1720471261
LBN Legal business name PACIFIC COAST MEDICAL GROUP COMPANY
Authorized official SHAILESH KOTHARI - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 03/09/2015
Last updated 03/09/2015 - About 11 years ago
Identifiers
GA License # 033801
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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