Provider Demographics
NPI:1043571391
Name:COASTAL DREAM DOCS INC
Entity Type:Organization
Organization Name:COASTAL DREAM DOCS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SEINK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-645-0000
Mailing Address - Street 1:2860 N SANTIAGO BLVD
Mailing Address - Street 2:STE 110
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-1722
Mailing Address - Country:US
Mailing Address - Phone:949-645-0000
Mailing Address - Fax:949-645-0003
Practice Address - Street 1:2860 N SANTIAGO BLVD
Practice Address - Street 2:STE 110
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-1722
Practice Address - Country:US
Practice Address - Phone:949-645-0000
Practice Address - Fax:949-645-0003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Multi-Specialty