COASTAL DIAGNOSTIC TESTING GROUP INC – NPI #1134894009
Clinic/Center

COASTAL DIAGNOSTIC TESTING GROUP INC is an AHC clinic located in BROOKINGS, OR. NPPES has assigned the NPI number 1134894009 to COASTAL DIAGNOSTIC TESTING GROUP INC on August 12, 2021. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QS1200X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Sleep Disorder Diagnostic

The NPI profile was previously updated about 3 years ago on Sep 06, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for COASTAL DIAGNOSTIC TESTING GROUP INC below.

NPI Profile for
COASTAL DIAGNOSTIC TESTING GROUP INC

NPI Number
1134894009
Enumeration Date

(about 5 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
COASTAL DIAGNOSTIC TESTING GROUP INC
Primary location
615 CHETCO AVE
STE A
BROOKINGS, OR 97415
Phone: (541) 412-9556 Fax: (541) 756-7699
Mailing address
1957 THOMPSON RD
SUITE E
COOS BAY, OR 97420
Phone: (541) 756-7710 Fax: (541) 756-7699
Organization Subpart
Yes - COASTAL DIAGNOSTIC TESTING GROUP INC is subpart of another organization.
Authorized Official
MEHRDAD GERAMI
PRESIDENT
Phone: (541) 756-7710
Updated
Certification Date
Aug 12, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for COASTAL DIAGNOSTIC TESTING GROUP INC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidOR500719439
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QS1200X
- Clinic/Center / Sleep Disorder Diagnostic (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.