Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Coastal Cardiology a Medical Corp

Organization Cardiovascular Disease Physician · NPI 1962664888

Coastal Cardiology a Medical Corp provides Cardiovascular Disease Physician services in San Luis Obispo, California. Licensed in California. Registered with an NPI since 2008.

Licensed in
CA
In the registry since
2008
Specialties on file
3
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1941 Johnson Ave Ste 102
San Luis Obispo, CA 93401-4154
Phone: (805) 782-8844
Fax: (813) 613-2633
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Cardiovascular Disease Physician (primary) Taxonomy 207RC0000X
Interventional Cardiology Physician Taxonomy 207RI0011X · Licence A114658 (CA)
Nuclear Medicine Physician Taxonomy 207U00000X

Record details

NPI number1962664888
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Marissa Famularo — Operations Manager · (805) 782-8844
NPI enumeratedJuly 1, 2008
Last updated in NPPESSeptember 9, 2025
Certification dateSeptember 9, 2025
Mailing addressPo Box 12003, San Luis Obispo, CA 93406-2003

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