# CENTRAL COAST PEDIATRIC SURGICAL ASSOCIATES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780198523
- **Authorized official:** ROBERT C KANARD MD (OWNER)
- **Authorized official phone:** (224) 420-0879

## Contact information

- **Practice address:** 400 W PUEBLO ST, SANTA BARBARA, CA 93105-4353
- **Practice address phone:** (805) 879-4271
- **Mailing address:** PO BOX 1359, SAN CLEMENTE, CA 92674-1359
- **Mailing address phone:** (949) 492-3514
- **Mailing address fax:** (949) 366-2390

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 2080P0203X | Pediatric Critical Care Medicine Physician | — | NULL | — |
| 2080P0203X | Pediatric Critical Care Medicine Physician | — | — | — |
| 2086S0120X | Pediatric Surgery Physician | — | NULL | Yes |
| 2086S0120X | Pediatric Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/30/2017
- **Last updated:** 11/30/2017