NPI 1003536830
Coastal Detox of Southern California LLC
Practice location
- Address
- 2574 Pico Way, San Diego, CA 92109-3811
- Phone
- (619) 386-7740
Authorised official
- Name
- Mercedes Cornejo
- Title
- Ceo
- Phone
- (949) 356-5301
Registered specialties
Substance Abuse Rehabilitation Facility
Primary
Registry record
- NPI
- 1003536830
- Entity type
- Organization
- NPI issued
- 31 Aug 2022
- Record last updated
- 23 Jul 2026
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.