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Organization
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.
Active
Organization
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.
Active
Other names
Community Health Centers, Santa Maria 3
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD E CASTLE (CHIEF EXECUTIVE OFFICER)
(805) 929-3211
Entity
Organization
Contact information
Practice address
1414 S MILLER ST, SUITE 9, SANTA MARIA, CA 93454-6923
(805) 934-5400
(805) 938-9207
Mailing address
150 TEJAS PL, PO BOX 430, NIPOMO, CA 93444-9123
(805) 929-3211
(805) 929-6440
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
550000721
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70477F
—
CA
01
—
HAP70477F
HEALTHY FAMILIES
CA
01
—
W1508
MEDICARE
CA
Enumeration date
07/07/2008
Last updated
07/07/2008
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