PACIFIC COAST MEDICAL SUPPLY (NPI# 1053707182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053707182 |
| Entity Type | Organization |
| Organization Name | PACIFIC COAST MEDICAL SUPPLY |
| Other Organization Name | GOLD COAST DIABETES |
| Practice Address |
1704 W Manchester Ave Suite 105 Los Angeles CA 90047-3063 |
| Mailing Address |
218 Chicago Ave Suite 8 Huntington Beach CA 92648-5292 |
| Practice Telephone | 5627064552 |
| Practice Fax Number | 8777333462 |
| Mailing Telephone | 5627064552 |
| Mailing Fax Number | 8777333462 |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2015-04-24 |
| Authorized Official Name | CARIE MORTENSEN (CEO/PRESIDENT) |
| Authorized Official Telephone | 5627064552 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| Gold Coast Diabetes | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427274927 | Pacific Coast Medical Supply | Durable Medical Equipment & Medical Supplies | 2158 Exchange St, Ste 106, Astoria, OR 97103-3316 | 2007-04-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PACIFIC COAST MEDICAL SUPPLY, INC. | 2158 Exchange St Ste 106, Astoria, OR 97103 |
| Street Address |
1704 W MANCHESTER AVE SUITE 105 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90047-3063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083643837 | Morningside Primary Care Medical Ctr, Inc | General Practice | 1704 W Manchester Ave, Suite 101, Los Angeles, CA 90047-3034 | 2006-07-02 |
| 1225662331 | Erika Hall | Case Manager/Care Coordinator | 1704 W Manchester Ave, Los Angeles, CA 90047-3063 | 2020-02-27 |
| 1083177372 | Jessica Bessette | Nurse Practitioner | 1704 W Manchester Ave, Los Angeles, CA 90047-3063 | 2019-04-12 |
| 1245637362 | God's Property Sober Living Foundation | Substance Abuse Rehabilitation Facility | 1704 W Manchester Ave, Suite 210, Los Angeles, CA 90047-3063 | 2014-12-04 |
| 1851702286 | Morningside Specialty Hospital Inc. | Special Hospital | 1704 W Manchester Ave, Suite 206k, Los Angeles, CA 90047-3063 | 2014-05-20 |
| 1053722256 | Loving Touch Hospice Care, Inc. | Hospice Care, Community Based | 1704 W Manchester Ave, Suite 101-d, Los Angeles, CA 90047-3063 | 2014-05-11 |
| 1982023628 | Jahreese Barber | Counselor | 1704 W Manchester Ave, Suite 203, Los Angeles, CA 90047-3063 | 2014-04-09 |
| 1245655745 | Brighter Beginnings Drug and Alcohol Rehabilitation Facility | Community/Behavioral Health | 1704 W Manchester Ave, Los Angeles, CA 90047-3063 | 2014-02-20 |
| 1518236017 | Nueva Esperanza Healthcare Medical Clinic Inc. | Family Medicine | 1704 W Manchester Ave, Suite 109, Los Angeles, CA 90047-3063 | 2011-12-29 |
| 1063781565 | Nueva Esperanza Healthcare Medical Clinic Inc. | Family Medicine | 1704 W Manchester Ave, Suite 109, Los Angeles, CA 90047-3063 | 2011-12-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063071652 | Cherae Nikia Stovall | Counselor | 1704 Manchester Boulevard, Suite 202, Los Angeles, CA 90047 | 2019-06-07 |
| 1598264053 | Dignity Health | Community/Behavioral Health | 1852 W Imperial Hwy, Los Angeles, CA 90047 | 2018-02-09 |
| 1750805222 | Brian George Martinez | Counselor | 1448 W 83rd St, Los Angeles, CA 90047 | 2017-07-27 |
| 1295266609 | Maria Amezcua | Rehabilitation Practitioner | 108 W Victoria Street, Gardena, CA 90047 | 2017-03-27 |
| 1265861140 | Ameika Porter | Counselor | 1529 West 82nd Street, Los Angeles, CA 90047 | 2013-11-01 |
| 1053747519 | Maria D Macias | Counselor | 11601 S. Western Avenue, Los Angeles, CA 90047 | 2013-09-16 |
| 1366704132 | Evelyn Carolina Hernandez | Family Medicine | 1555 West 110th Street, Los Angeles, CA 90047 | 2012-06-08 |
| 1003057142 | Sandra Patricia Trim | Licensed Vocational Nurse | 2048 W 69 St, Los Angeles, CA 90047 | 2009-03-19 |
| 1194962001 | Estuardo Ardon | Counselor | 11603 S. Western Ave., Los Angeles, CA 90047 | 2009-01-14 |
| 1174788400 | Frenda Brigette Williams | Dentist | 2015 W 81st St, Los Angeles, CA 90047 | 2008-07-25 |
| Find all providers in zip 90047 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700484219 | Oa Medicals LLC | Durable Medical Equipment & Medical Supplies | 1704 W Manchester Ave Ste 203, Los Angeles, CA 90047-3057 | 2020-10-16 |
| 1598376790 | Supercare Depot Inc | Durable Medical Equipment & Medical Supplies | 11901 Santa Monica Blvd Ste 470, Los Angeles, CA 90025-2767 | 2020-08-11 |
| 1568089548 | Dmg Wellness Inc. | Durable Medical Equipment & Medical Supplies | 2651 Nevin Ave, Los Angeles, CA 90011-2242 | 2020-06-25 |
| 1467073098 | Revive Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 232 E 2nd St Apt 752, Los Angeles, CA 90012-4539 | 2020-05-05 |
| 1558993527 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 5500 West Sunset Boulevard, Los Angeles, CA 90028 | 2020-02-07 |
| 1386276400 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 8900 S Sepulveda Blvd, Los Angeles, CA 90045-3604 | 2020-02-06 |
| 1366074676 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 415 S La Brea Ave, Los Angeles, CA 90036-3523 | 2020-02-05 |
| 1689214744 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 555 N Broadway # B101, Los Angeles, CA 90012-4700 | 2020-01-07 |
| 1548816291 | Cath Dry, Inc. | Durable Medical Equipment & Medical Supplies | 1243 N Hoover St, Los Angeles, CA 90029-2009 | 2019-08-16 |
| 1386299139 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 1302 South La Brea, Los Angeles, CA 90019 | 2019-08-08 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90047 |
Please comment or provide details below to improve the information on PACIFIC COAST MEDICAL SUPPLY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.