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Organization
CENTRAL COAST OBSTETRICS & GYNECOLOGY, INC.
Active
Organization
CENTRAL COAST OBSTETRICS & GYNECOLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANNY LEROY LICKNESS MD (PRESIDENT)
(805) 544-8811
Entity
Organization
Contact information
Practice address
350 POSADA LANE, SUITE 202, TEMPLETON, CA 93405-1890
(805) 434-5497
(805) 434-0917
Mailing address
100 CASA STREET, SUITE B, SAN LUIS OBISPO, CA 93465-4060
(805) 548-0775
(805) 548-0777
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
04/16/2008
Last updated
06/24/2010
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