COASTAL FAMILY DERMATOLOGY, PC
NPI 1174927073
Dermatology - Pediatric Dermatology in San Luis Obispo, CA
NPI Status: Active since October 21, 2014
Contact Information
990 PACIFIC ST
SAN LUIS OBISPO, CA
ZIP 93401
Phone: (805) 554-5567
Fax: (805) 544-3265
- Organization
- Dermatology
- Pediatric Dermatology
- CLIA Number: 05D2165534
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 03-06-2026
About COASTAL FAMILY DERMATOLOGY, PC
This page provides the complete NPI Profile along with additional information for Coastal Family Dermatology, Pc, a provider established in San Luis Obispo, California operating as a Dermatology, focusing in pediatric dermatology . The healthcare provider is registered in the NPI registry with number 1174927073 assigned on October 2014. The practitioner's primary taxonomy code is 207NP0225X with license number A72400 (CA). The provider is registered as an organization and their NPI record was last updated 11 years ago. Coastal Family Dermatology, Pc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Christine Denise Kilcline M.d. (M.d./owner)
- NPI
- 1174927073
- Provider Name
- COASTAL FAMILY DERMATOLOGY, PC
- Entity Type
- Organization
- Location Address
- 990 PACIFIC ST SAN LUIS OBISPO, CA 93401
- Location Phone
- (805) 554-5567
- Location Fax
- (805) 544-3265
- Mailing Address
- 990 PACIFIC ST SAN LUIS OBISPO, CA 93401
- Mailing Phone
- (805) 544-5567
- Mailing Fax
- (805) 544-3265
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-21-2014
- Last Update Date
- 01-02-2015
- Code Navigator
A dermatologist like Coastal Family Dermatology, Pc is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dermatology Pediatric Dermatology
- Taxonomy Code
- 207NP0225X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- A72400
- License State
- CA
- Taxonomy Description
- A pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emphasis on those diseases which predominate in infants, children and adolescents.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207NS0135X | Allopathic & Osteopathic Physicians | Dermatology | A72400 (CA) |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D2165534
- Facility Type
- Physician Office
- Certificate Effective Date
- March 07, 2024
- Certificate Expiration Date
- March 06, 2026
- Laboratory Director
- CHRISTINE D. KILCLINE
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Coastal Family Dermatology, Pc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
Reviews for COASTAL FAMILY DERMATOLOGY, PC
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 7 | 4 | 9 | 2 | 7 | 0 | 7 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 14 | 4 | 18 | 2 | 14 | 0 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 4 + 4 + 1 + 8 + 2 + 1 + 4 + 0 + 1 + 4 + 24 = 57 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 57 = 3 | 3 | ||||||||
The NPI number 1174927073 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1053389247 | DR. JAMES LEE LONGABAUGH MD12 Individual | Dermatology (Procedural Dermatology) | 990 PACIFIC ST SAN LUIS OBISPO, CA 93401 (805) 544-5567 |
| 1063781557 | LISA LINDVALL AQUINO MD Individual | Dermatology | 990 PACIFIC ST SAN LUIS OBISPO, CA 93401 (805) 544-5567 |
| 1093724791 | CHRISTINE DENISE KILCLINE M.D. Individual | Dermatology (Procedural Dermatology) | 990 PACIFIC ST SAN LUIS OBISPO, CA 93401 (805) 544-5567 |
| 1083197354 | NATALIE MATENAER PA-C Individual | Physician Assistant | 990 PACIFIC ST SAN LUIS OBISPO, CA 93401 (805) 544-5567 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174927073, enumerated in the NPI registry as an "organization" on October 21, 2014
The provider is located at 990 Pacific St San Luis Obispo, Ca 93401 and the phone number is (805) 554-5567
This medical organization specializes in Dermatology with taxonomy code 207NP0225X with a focus in Pediatric Dermatology
The provider's CLIA number is 05D2165534 for a "physician office" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on October 21, 2014. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.