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Organization
CENTRAL COAST PEDIATRICS INC
Active
Organization
CENTRAL COAST PEDIATRICS INC
Active
Parent organization
CENTRAL COAST PEDIATRICS INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRAL COAST PEDIATRICS INC
Authorized official
DR. RICHRD J MACIAS MD (PRES/CFO)
(805) 549-0888
Entity
Organization
Contact information
Practice address
1320 LAS TABLAS RD, SUITE D, TEMPLETON, CA 93465-9711
(805) 434-3796
Mailing address
1320 LAS TABLAS RD, SUITE D, TEMPLETON, CA 93465-9711
(805) 434-3796
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0059300
—
CA
Enumeration date
11/20/2008
Last updated
05/05/2022
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