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COASTAL CARDIOLOGY A MEDICAL CORP
NPI 1578725495
Internal Medicine - Cardiovascular Disease in Arroyo Grande, CA

Active since July 01, 2008CLIA 05D2084691 · Waiver
310 SOUTH HALCYON ROAD STE 105, ARROYO GRANDE, CA 93420(805) 782-8844(813) 613-2632 Get Directions Write a Review

NPPES record last updated: September 9, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Sep 9, 2025, Jul 9, 2022, Nov 2, 2021 and 3 more (6 updates tracked since 2018).

About Coastal Cardiology A Medical Corp NPPES

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

COASTAL CARDIOLOGY A MEDICAL CORP (NPI 1578725495) is a healthcare organization registered as a cardiovascular disease in Arroyo Grande, California and active in the NPI registry since July 2008. The organization holds a CLIA Waiver certificate valid through September 28, 2026 and lists Marissa Famularo, Operations Manager, as its authorized official.

NPPES Registry Identity

NPI1578725495
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NameCOASTAL CARDIOLOGY A MEDICAL CORP
Location Address310 SOUTH HALCYON ROAD STE 105Arroyo Grande, CA 93420-3872
Mailing AddressPo Box 12003San Luis Obispo, CA 93406-2003 · (805) 782-8844 · Fax (805) 540-5881
Phone(805) 782-8844
Fax(813) 613-2632
Organization SubpartNo
Authorized OfficialMarissa FamularoOperations Manager · (805) 782-8844
Enumeration DateJuly 1, 2008
Last NPPES UpdateSeptember 9, 20256 updates tracked since enumeration
NPPES CertifiedSeptember 9, 2025
✔ NPI 1578725495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Also ListedInternal Medicine · Interventional CardiologyTaxonomy 207RI0011X · License A114658 (CA)
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License PA23186 (CA)
310 SOUTH HALCYON ROAD STE 105, Arroyo Grande, CA 93420
Open in Google Maps ↗

Other Identifiers 2

MedicaidGR0068680CA
OtherZZZ24859ZCA · Blue Shield

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

CLIA Laboratory Certificates CMS CLIA

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 Waiver 05D2084691

Coastal Cardiology - Diagnostic Center · San Luis Obispo, CA
Active · expires Sep 28, 2026
CLIA Number05D2084691
Laboratory TypeCommunity Clinic
Certificate Effective DateSeptember 29, 2024
Certificate Expiration DateSeptember 28, 2026
Laboratory DirectorLorianna P. Fletcher, MD
Laboratory Phone(805) 782-8844
Laboratory LocationCoastal Cardiology - Diagnostic Center1941 Johnson Ave Ste 102, San Luis Obispo, CA 93401
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Cardiology A Medical Corp's NPI number?

The NPI number for Coastal Cardiology A Medical Corp is 1578725495. It was assigned to this organization in the NPPES registry on July 1, 2008.

Where is Coastal Cardiology A Medical Corp located?

Coastal Cardiology A Medical Corp is located at 310 South Halcyon Road Ste 105, Arroyo Grande, CA 93420. The listed phone number is (805) 782-8844.

What is Coastal Cardiology A Medical Corp's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Does Coastal Cardiology A Medical Corp hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2084691) is associated with this NPI, valid through September 28, 2026. 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 Cardiology A Medical Corp was last updated on September 9, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.