COASTAL REGENERATIVE ORTHOPEDICS & WELLNESS CENTER INC. (NPI# 1275165979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275165979 |
| Entity Type | Organization |
| Organization Name | COASTAL REGENERATIVE ORTHOPEDICS & WELLNESS CENTER INC. |
| Other Organization Name | COASTAL REGENERATIVE ORTHOPEDICS & WELLNESS CENTER |
| Practice Address |
11772 Sorrento Valley Rd Ste 100 San Diego CA 92121-1016 |
| Practice Telephone | 8582214229 |
| Practice Fax Number | 8583454828 |
| Mailing Telephone | 8582214229 |
| Mailing Fax Number | 8583454828 |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2020-02-11 |
| Authorized Official Name | VICTORIA MARX (BILLER) |
| Authorized Official Telephone | 7143084995 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081S0010X |
Physical Medicine & Rehabilitation Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Coastal Regenerative Orthopedics & Wellness Center | Doing Business As Name - Organization |
| Street Address |
11772 SORRENTO VALLEY RD STE 100 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92121-1016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644917 | Anna Hand | Physical Therapist | 5945 Pacific Center Blvd Bldg #510, San Diego, CA 92121 | 2020-09-18 |
| 1972138030 | Lamarr Joyner | Licensed Vocational Nurse | 5930 Conerstone Court West, Suite 300, San Diego, CA 92121 | 2020-03-10 |
| 1396383212 | La Jolla Professional Plastic Surgery | Plastic Surgery | 4510 Executive Dr. Suite 105, San Diego, CA 92121 | 2019-12-11 |
| 1841852472 | Unmanned Systems Operations Group | Air Carrier | 4655 Executive Dr., Suite 700, San Diego, CA 92121 | 2019-07-03 |
| 1861051922 | Grace Getchell | Behavior Technician | 3978 Sorrento Valley Blvd. #100, San Diego, CA 92121 | 2019-06-11 |
| 1720643299 | Megan Jean Bathen | Behavior Technician | Cortica Behavioral Inc., 7090 Miratech Dr., San Diego, CA 92121 | 2019-05-09 |
| 1346804366 | Daniel Melita | Massage Therapist | 11689 Sorrento Valley Rd Ste Q, San Diego, CA 92121 | 2019-04-25 |
| 1831674464 | Stepahnie Becerra | Behavior Technician | 3978 Sorrento Valley Blvd Suite 100, San Diego, CA 92121 | 2018-09-28 |
| 1265915466 | Ailyn Martinez | Behavior Technician | 3978 Sorrento Valley Bldv, 100, San Diego, CA 92121 | 2018-09-13 |
| 1790265163 | Genben Lifesciences Corporation | Public Health or Welfare | 6370 Lusk Blvd Ste F205, San Diego, CA 92121 | 2018-08-15 |
| Find all providers in zip 92121 | ||||
| Taxonomy Code | 2081S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Sports Medicine |
| A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. |
| Notes: Source: American Board of Medical Specialties, 2009. www.abms.org [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255969143 | Amber Renee Debarge | Physical Medicine & Rehabilitation | 2918 Havasupai Ave, San Diego, CA 92117-1641 | 2020-03-28 |
| 1417460338 | Tyler Nguyen | Physical Medicine & Rehabilitation | 6356 Mesita Dr, San Diego, CA 92115-2529 | 2017-11-14 |
| 1780077230 | Cpms Medical Group | Physical Medicine & Rehabilitation | 4510 Executive Dr Ste 210, San Diego, CA 92121-3023 | 2015-03-09 |
| 1154433704 | Robert E Scott Jr. | Physical Medicine & Rehabilitation | 6719 Alvarado Rd Ste 200, San Diego, CA 92120-5256 | 2006-08-31 |
| 1992311690 | Matthew Friedman | Physical Medicine & Rehabilitation | 12625 High Bluff Dr Ste 105, San Diego, CA 92130-2053 | 2020-09-17 |
| 1639712433 | Mary Foster | Physical Medicine & Rehabilitation | 15004 Innovation Dr, San Diego, CA 92128-3491 | 2019-10-24 |
| 1710207931 | Activerx Physical Therapy | Physical Medicine & Rehabilitation | 4765 Carmel Mountain Rd, Suite 102, San Diego, CA 92130-6657 | 2010-06-10 |
| 1336256650 | Geraldine Kuo | Physical Medicine & Rehabilitation | 3350 La Jolla Village Dr, Mail Code 117, San Diego, CA 92161-0002 | 2006-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518578186 | Tracy Tran Physical Therapy | Physical Medicine & Rehabilitation | 5166 Eagle Rock Blvd, Los Angeles, CA 90041-1115 | 2020-08-16 |
| 1932734969 | Jasmine Angelina Velasquez | Physical Medicine & Rehabilitation | 12017 Herbert St, Los Angeles, CA 90066-5201 | 2020-03-10 |
| 1679110407 | Drew Yoder | Physical Medicine & Rehabilitation | Chase Center - Bbops, 1 Warriors Way, San Francisco, CA 94158 | 2019-11-27 |
| 1841831864 | Olivia Carmen Smith | Physical Medicine & Rehabilitation | 2439 Country Club Dr, Glendora, CA 91741-4009 | 2019-10-01 |
| 1538719521 | Kyle Watry | Physical Medicine & Rehabilitation | 550 15th St Ste 36a, San Francisco, CA 94103-5032 | 2019-09-12 |
| 1023679826 | Adrianna Medina | Physical Medicine & Rehabilitation | 279 E Orlando Way, Covina, CA 91723-3016 | 2019-06-24 |
| 1316505563 | Restore The Machine - Physical Therapy Inc | Physical Medicine & Rehabilitation | 23332 Hawthorne Blvd Ste 202, Torrance, CA 90505-3767 | 2019-06-03 |
| 1881163889 | Gaylen Mcginn | Physical Medicine & Rehabilitation | 724 W Maple Ave Apt A, Orange, CA 92868-5022 | 2018-11-19 |
| 1326532417 | Nicolas Simo | Physical Medicine & Rehabilitation | 742 Bonnie Claire Dr, Walnut, CA 91789-4185 | 2018-06-21 |
| 1922591155 | Rahul Yogee Katbamna | Physical Medicine & Rehabilitation | 15 Lynnfield, Irvine, CA 92620-1987 | 2018-06-12 |
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| 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.