Provider Demographics
NPI:1336804947
Name:PALOMARKLN INFUSION CENTER
Entity Type:Organization
Organization Name:PALOMARKLN INFUSION CENTER
Other - Org Name:PACIFIC KLN INFUSIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
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:858-256-6868
Mailing Address - Fax:
Practice Address - Street 1:334 VIA VERA CRUZ STE 205
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-2640
Practice Address - Country:US
Practice Address - Phone:760-276-3323
Practice Address - Fax:866-272-1965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-08
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty