COASTAL FAMILY DERMATOLOGY, PC (NPI# 1295290567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295290567 |
| Entity Type | Organization |
| Organization Name | COASTAL FAMILY DERMATOLOGY, PC |
| Practice Address |
892 Aerovista Pl Ste 120 San Luis Obispo CA 93401-8054 |
| Practice Telephone | 8055445567 |
| Practice Fax Number | 8055443265 |
| Mailing Telephone | 8055445567 |
| Mailing Fax Number | 8055443265 |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2019-01-31 |
| Authorized Official Name | CHRISTINE DENISE KILCLINE (MD/OWNER) |
| Authorized Official Telephone | 8055445567 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
Allopathic & Osteopathic Physicians | ||
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174927073 | Coastal Family Dermatology, PC | Dermatology | 990 Pacific St, San Luis Obispo, CA 93401-6309 | 2014-10-21 |
| Street Address |
892 AEROVISTA PL STE 120 |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip Code | 93401-8054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497228399 | Barbara Jean Morrow | Dental Hygienist | 2191 Johnson Avenue, San Luis Obispo, CA 93401 | 2019-01-03 |
| 1104307743 | Griffith Jennings | Counselor | 1225 Kendal Rd, San Luis Obispo, CA 93401 | 2018-08-22 |
| 1124518808 | Joy L Delaluna | Licensed Psychiatric Technician | 692 Evens Rd, San Luis Obispo, CA 93401 | 2018-05-17 |
| 1982192084 | Sierra Mental Wellness Group | Community/Behavioral Health | 2180 B Johnson Avenue, San Luis Obispo, CA 93401 | 2018-04-25 |
| 1326554403 | Veronica Chanel Laguna | Case Manager/Care Coordinator | 1065 Kansas Ave., San Luis Obispo, CA 93401 | 2017-12-27 |
| 1043739782 | Janette Lynn Branca | Case Manager/Care Coordinator | 285 South Street, Suit J, San Louis Obispo, CA 93401 | 2017-09-13 |
| 1588194104 | Adv Vision LLC | Optometrist | 835 Aero Vista Pl, #110, San Luis Obispo, CA 93401 | 2017-06-15 |
| 1508395880 | Samantha Clay | Counselor | 1255 Kendall Road, San Luis Obispo, CA 93401 | 2017-06-08 |
| 1659804771 | Sara Anne Powers | Counselor | 697 Higuera Street D, San Luis Obispo, CA 93401 | 2017-04-05 |
| 1508306010 | Russell Piazza | Pharmacist | 873 Ricardo Court, San Luis Obispo, CA 93401 | 2017-03-02 |
| Find all providers in zip 93401 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942200183 | Karen Denise Allen | Dermatology | 715 Tank Farm Rd, San Luis Obispo, CA 93401-7068 | 2005-07-29 |
| 1063781557 | Lisa Lindvall Aquino | Dermatology | 990 Pacific St, San Luis Obispo, CA 93401-6309 | 2011-12-29 |
| 1588985113 | Laura Frances Sandoval | Dermatology | 805 Aerovista Pl Ste 202, San Luis Obispo, CA 93401-7920 | 2010-06-17 |
| 1508199431 | Blanca Bisuna | Dermatology | 1250 Peach Street, Suite A, San Luis Obispo, CA 93401-2837 | 2009-09-10 |
| 1265616361 | Jennifer Remington | Dermatology | 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 | 2007-12-26 |
| 1255528113 | Charles B. Fishman, M.d., A Professional Corporation | Dermatology | 1551 Bishop St, Suite 410, San Luis Obispo, CA 93401-4635 | 2007-09-25 |
| 1437361771 | Paul Stephen Collins | Dermatology | 84 Santa Rosa St, San Luis Obispo, CA 93405-1812 | 2007-05-07 |
| 1730279944 | R Jeffrey Herten Md Inc | Dermatology | 15 Santa Rosa Street, San Luis Obispo, CA 93405-1811 | 2006-10-16 |
| 1194825752 | Charles B. Fishman | Dermatology | 1551 Bishop St, Suite 410, San Luis Obispo, CA 93401-4635 | 2006-09-24 |
| 1518923432 | Michael P Heffernan | Dermatology | 15 Santa Rosa St, San Luis Obispo, CA 93405-1811 | 2006-04-21 |
| Find all providers in SAN LUIS OBISPO | ||||
| City | SAN LUIS OBISPO |
| Zip Code | 93401 |
Please comment or provide details below to improve the information on COASTAL FAMILY DERMATOLOGY, PC.
| 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.