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Organization
CENTRAL COAST CARDIOTHORACIC SURGICAL ASSOCIATES-A MEDICAL GROUP
Active
Organization
CENTRAL COAST CARDIOTHORACIC SURGICAL ASSOCIATES-A MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA M KENT (OFFICE MANAGER)
(805) 556-6001
Entity
Organization
Contact information
Practice address
911 OAK PARK BLVD, STE 102, PISMO BEACH, CA 93449-3405
(805) 556-6001
(805) 773-4232
Mailing address
911 OAK PARK BLVD, STE 102, PISMO BEACH, CA 93449-3405
(805) 556-6001
(805) 773-4232
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
NULL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Enumeration date
07/10/2006
Last updated
03/01/2017
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