Provider Demographics
NPI:1790418036
Name:DUSTIN E. COYLE MD PC
Entity Type:Organization
Organization Name:DUSTIN E. COYLE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:COYLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-598-1779
Mailing Address - Street 1:1487 EAGLE GLN
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-3139
Mailing Address - Country:US
Mailing Address - Phone:801-598-1779
Mailing Address - Fax:
Practice Address - Street 1:1487 EAGLE GLN
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92029-3139
Practice Address - Country:US
Practice Address - Phone:801-598-1779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-05
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty