COASTAL FAMILY DERMATOLOGY, PC
NPI 1174927073
Dermatology - Pediatric Dermatology in San Luis Obispo, CA

Q: What is Coastal Family Dermatology, PC's NPI number?

The NPI number for Coastal Family Dermatology, PC is 1174927073. It was assigned to this organization in the NPPES registry on October 21, 2014.

Q: What is Coastal Family Dermatology, PC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Pediatric Dermatology, with taxonomy code 207NP0225X.

Active since October 21, 2014CLIA 05D2330662 · Certificate of Compliance

892 AEROVISTA PL STE 120, SAN LUIS OBISPO, CA 93401(805) 544-5567(805) 544-3265 Get Directions Write a Review

NPPES record last updated: July 15, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Coastal Family Dermatology, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COASTAL FAMILY DERMATOLOGY, PC (NPI 1174927073) is a healthcare organization registered as a pediatric dermatology in San Luis Obispo, California and active in the NPI registry since October 2014. The organization holds a CLIA Certificate of Compliance certificate valid through September 18, 2027, maintains a secondary practice location in Santa Maria, and lists Christine Denise Kilcline, M.d./owner, as its authorized official.

NPPES Registry Identity

NPI1174927073

Entity TypeOrganization

Primary Taxonomy207NP0225X

Legal Business NameCOASTAL FAMILY DERMATOLOGY, PC

Location Address892 AEROVISTA PL STE 120San Luis Obispo, CA 93401-8054

Mailing Address892 Aerovista Pl Ste 120San Luis Obispo, CA 93401-8054 · (805) 544-5567 · Fax (805) 544-3265

Phone(805) 544-5567

Fax(805) 544-3265

Organization SubpartNo

Authorized OfficialChristine Denise KilclineM.d./owner · (805) 544-5567

Enumeration DateOctober 21, 2014

Last NPPES UpdateJuly 15, 2025

NPPES CertifiedJuly 15, 2025

✔ NPI 1174927073 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatology · Pediatric DermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207NP0225X

License✔ Licensed in CA · A72400

Definition

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.

Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X · License A72400 (CA)

892 AEROVISTA PL STE 120, San Luis Obispo, CA 93401

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Secondary Practice Location 1

Location 1525 Plaza Dr Ste 200Santa Maria, CA 93454-6954 · Phone (805) 544-5567 · Fax (805) 544-3265

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Coastal Family Dermatology, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 3 clinicians reassign Medicare billing to Coastal Family Dermatology, PC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Christine Kilcline, M.D.

Dermatology

NPI 1093724791

892 AEROVISTA PL STE 120
San Luis Obispo, CA 93401

(805) 544-5567

✔ PECOS✔ Accepts MedicareSame address

Joshua Spanogle, M.D.

Dermatology

NPI 1750564407

2290 SACRAMENTO ST
Vallejo, CA 94590

(707) 643-5785

✔ PECOS✔ Accepts Medicare218 mi

Laura De La Cruz, NP

Nurse Practitioner

NPI 1144616251

100 INDEPENDENCE CIR
Chico, CA 95973

(530) 899-2095

✔ PECOS✔ Accepts Medicare320 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 05D2330662

Coastal Family Dermatology, PC · Santa Maria, CA

Active · expires Sep 18, 2027

CLIA Number05D2330662

Laboratory TypePhysician Office

Certificate Effective DateSeptember 19, 2025

Certificate Expiration DateSeptember 18, 2027

Laboratory DirectorChristine D. Kilcline

Laboratory Phone(805) 544-4467

Laboratory LocationCoastal Family Dermatology, PC525 Plaza Dr Ste 200, Santa Maria, CA 93454

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 05D2165534

Coastal Family Dermatology, PC · San Luis Obispo, CA

Expired · Sep 30, 2026

CLIA Number05D2165534

Laboratory TypePhysician Office

Certificate Effective DateMarch 7, 2024

Certificate Expiration DateSeptember 30, 2026

Laboratory DirectorChristine D. Kilcline

Laboratory Phone(805) 544-5567

Laboratory LocationCoastal Family Dermatology, PC892 Aerovista Pl Ste 120, San Luis Obispo, CA 93401

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Coastal Family Dermatology, PC's NPI number?

The NPI number for Coastal Family Dermatology, PC is 1174927073. It was assigned to this organization in the NPPES registry on October 21, 2014.

Where is Coastal Family Dermatology, PC located?

Coastal Family Dermatology, PC is located at 892 Aerovista Pl Ste 120, San Luis Obispo, CA 93401. The listed phone number is (805) 544-5567.

What is Coastal Family Dermatology, PC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Pediatric Dermatology, with taxonomy code 207NP0225X.

Is Coastal Family Dermatology, PC enrolled in Medicare?

Yes. Coastal Family Dermatology, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Coastal Family Dermatology, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Coastal Family Dermatology, PC, in Dermatology and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Coastal Family Dermatology, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 05D2330662) is associated with this NPI, valid through September 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Coastal Family Dermatology, PC was last updated on July 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.