Coastal Community Center Inc

LBN: Coastal Community Center Inc
Coastal Community Center Inc is an health care organization with primary practice located at 3650 N University Ave Ste 150 , Provo UT 84604-6636. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Primary Care is the primary health care specialty. Coastal Community Center Inc can be contacted via phone (702) 809-2505, or through Srinivasa, Ayushmaan via phone (702) 809-2505.

Contact Information

Primary practice address
3650 N University Ave Ste 150 Provo UT 84604-6636
Phone: (702) 809-2505
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Srinivasa, Ayushmaan
Phone: (702) 809-2505

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X

Profile Details

NPI number 1295690527
LBN Legal business name Coastal Community Center Inc
DBA Doing business as
Authorized official Srinivasa, Ayushmaan
Entity Organization
Organization subpart 1 No
Enumeration date Dec 18th, 2025
Last updated Dec 18th, 2025 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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