Provider Demographics
NPI:1588840961
Name:COAST UNIFIED SCHOOL DISTRICT
Entity type:Organization
Organization Name:COAST UNIFIED SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-927-3880
Mailing Address - Street 1:3223 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIA
Mailing Address - State:CA
Mailing Address - Zip Code:93428-3537
Mailing Address - Country:US
Mailing Address - Phone:805-927-3880
Mailing Address - Fax:805-927-7105
Practice Address - Street 1:1350 MAIN ST
Practice Address - Street 2:
Practice Address - City:CAMBRIA
Practice Address - State:CA
Practice Address - Zip Code:93428-3304
Practice Address - Country:US
Practice Address - Phone:805-927-3880
Practice Address - Fax:805-927-7105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASS4075465Medicaid