Provider Demographics
NPI:1508261652
Name:COASTAL VIEW SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:COASTAL VIEW SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:B
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:FACOG
Authorized Official - Phone:805-965-3400
Mailing Address - Street 1:536 E ARRELLAGA ST
Mailing Address - Street 2:# 201
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-2264
Mailing Address - Country:US
Mailing Address - Phone:805-965-3400
Mailing Address - Fax:805-965-1222
Practice Address - Street 1:536 E ARRELLAGA ST
Practice Address - Street 2:# 201
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-2264
Practice Address - Country:US
Practice Address - Phone:805-965-3400
Practice Address - Fax:805-965-1222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-31
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81775261QA0006X, 261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QA0006XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Fertility Facility