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

Coastal Village Primary, Inc

Organization Family Medicine Physician · NPI 1396080511

Coastal Village Primary, Inc provides Family Medicine Physician services in Pismo Beach, California. Licensed in California. Registered with an NPI since 2012.

Licensed in
CA
In the registry since
2012
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2 James Way Ste 209
Pismo Beach, CA 93449-4973 Not confirmed with CMS for 13 years — call before visiting
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 number1396080511
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joseph Cruz — President/Owner · (805) 773-7440
NPI enumeratedNovember 28, 2012
Last updated in NPPESNovember 28, 2012
Mailing address2 James Way, Suite 209, Pismo Beach, CA 93449-4973

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