# CENTRAL COAST CARDIOTHORACIC SURGICAL ASSOCIATES-A MEDICAL GROUP

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

## Provider details

- **NPI number:** 1871527838
- **Authorized official:** MS. LISA M KENT (OFFICE MANAGER)
- **Authorized official phone:** (805) 556-6001

## Contact information

- **Practice address:** 911 OAK PARK BLVD, STE 102, PISMO BEACH, CA 93449-3405
- **Practice address phone:** (805) 556-6001
- **Practice address fax:** (805) 773-4232
- **Mailing address:** 911 OAK PARK BLVD, STE 102, PISMO BEACH, CA 93449-3405
- **Mailing address phone:** (805) 556-6001
- **Mailing address fax:** (805) 773-4232

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/10/2006
- **Last updated:** 03/01/2017