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

Coastal Village Primary Care, a Medical Group

Organization Family Medicine Physician · NPI 1053742528

Coastal Village Primary Care, a Medical Group is a Family Medicine Physician in Pismo Beach, California. Licensed in California. Registered with an NPI since 2013.

Licensed in
CA
In the registry since
2013
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Practice location Address checks out

2 James Way Ste 209
Pismo Beach, CA 93449-4976
Phone: (805) 773-7440
Fax: (805) 773-7448
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A49080 (CA)

Record details

NPI number1053742528
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joseph Cruz — President/Md · (805) 773-7440
NPI enumeratedDecember 9, 2013
Last updated in NPPESDecember 9, 2013
Mailing addressPo Box 428, Grover Beach, CA 93483-0428

Other providers in Pismo Beach