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Organization
CENTRAL COAST URGENT CARE MEDICAL GROUP
Active
Organization
CENTRAL COAST URGENT CARE MEDICAL GROUP
Active
Other names
Central Coast Urgent Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS A CARUSO MD (PHYSICIAN PARTNER)
(805) 922-0561
Entity
Organization
Contact information
Practice address
340 EAST BETTERAVIA RD, SUITE C, SANTA MARIA, CA 93454-7847
(805) 922-0561
(805) 922-0083
Mailing address
PO BOX 848722, BOSTON, MA 02284-8722
(805) 922-0561
(805) 922-0083
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083643878
NPI
CA
01
—
1245327840
NPI
CA
01
—
1376510529
NPI
CA
01
—
1437246022
NPI
CA
01
—
1609965433
NPI
CA
01
—
1891840088
NPI
CA
01
—
W8259
MEDICARE GROUP ID
CA
01
—
WA50123B
MEDICARE PPIN
CA
01
—
WG32607A
MEDICARE PPIN
CA
01
—
WG48284A
MEDICARE PPIN
CA
01
—
WG61780E
MEDICARE PPIN
CA
01
—
WPT10965B
MEDICARE PPIN
CA
01
—
WPT8518A
MEDICARE PPIN
CA
01
—
ZZZ16208Z
BLUE SHIELD
CA
Enumeration date
01/25/2007
Last updated
06/17/2009
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