# CENTRAL COAST INSTITUTE FOR PLASTIC SURGERY, AMC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gary R Donath MD Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053589077
- **Authorized official:** DR. GARY R DONATH MD (PRESIDENT)
- **Authorized official phone:** (805) 544-6000

## Contact information

- **Practice address:** 1531 HIGUERA ST, SAN LUIS OBISPO, CA 93401-2917
- **Practice address phone:** (805) 544-6000
- **Practice address fax:** (805) 544-5460
- **Mailing address:** 1531 HIGUERA ST, SAN LUIS OBISPO, CA 93401-2917
- **Mailing address phone:** (805) 544-6000
- **Mailing address fax:** (805) 544-5460

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | A50869 | CA | Yes |

## Other

- **Enumeration date:** 02/12/2008
- **Last updated:** 05/21/2008