Coastal Addiction Professionals | |
1600 N Rose Ave Oxnard CA 93030-3722 | |
(602) 844-4855 | |
Not Available |
Full Name | Coastal Addiction Professionals |
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Speciality | Internal Medicine |
Location | 1600 N Rose Ave, Oxnard, California |
Authorized Official Name and Position | Tipu Khan (OWNER) |
Authorized Official Contact | 8056526228 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Coastal Addiction Professionals 300 Hillmont Ave Blvd. 340-120 Ventrua CA 93003 Ph: () - | Coastal Addiction Professionals 1600 N Rose Ave Oxnard CA 93030-3722 Ph: (602) 844-4855 |
NPI Number | 1386354280 |
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Provider Enumeration Date | 12/01/2022 |
Last Update Date | 12/01/2022 |
Medicare PECOS PAC ID | 7517324791 |
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Medicare Enrollment ID | O20230602000367 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386354280 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
207RA0401X | Internal Medicine - Addiction Medicine | (* (Not Available)) | Primary |
Provider Name | Tipu Vahid Khan |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1801059555 PECOS PAC ID: 2567636178 Enrollment ID: I20111116000857 |
Provider Name | Tommaso Tosini |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1144750464 PECOS PAC ID: 2961824396 Enrollment ID: I20200612000365 |
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