Organization
CENTRAL COAST KIDNEY DISEASE CENTER INC.
Active
Organization
CENTRAL COAST KIDNEY DISEASE CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MUTHIYALIAH BABU M.D. (ADMINISTRATOR)
(805) 349-0198
Entity
Organization
Contact information
Practice address
2263 S. DEPOT RD., SANTA MARIA, CA 93455
(805) 349-8600
(805) 928-5145
Mailing address
116 S PALISADE DR, 100, SANTA MARIA, CA 93454-8904
(805) 614-0694
(805) 349-9004
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CDC02871F
—
CA
Enumeration date
07/07/2006
Last updated
12/07/2011
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