Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Coastal Detox of Southern California LLC

Organization Substance Abuse Rehabilitation Facility · NPI 1003536830

Coastal Detox of Southern California LLC is a Substance Abuse Rehabilitation Facility in San Diego, California. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2574 Pico Way
San Diego, CA 92109-3811
Phone: (619) 386-7740
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Substance Abuse Rehabilitation Facility (primary) Taxonomy 324500000X

Record details

NPI number1003536830
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mercedes Cornejo — Ceo · (949) 356-5301
NPI enumeratedAugust 31, 2022
Last updated in NPPESJuly 23, 2026
Certification dateJuly 23, 2026
Mailing address2574 Pico Way, San Diego, CA 92109-3811

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