Organization
CENTRAL COAST FAMILY CARE MEDICAL ASSOCIATES, INC
Active
Other names
Central Coast Family Care Medical Associates of Santa Maria, Inc., Central Coast Family Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURA JEAN THEIS M.D. (PRESIDENT)
(805) 349-1227
Entity
Organization
Contact information
Practice address
821 E CHAPEL ST STE 203, SANTA MARIA, CA 93454-4619
(805) 925-5334
(805) 922-5923
Mailing address
220 S PALISADE DR STE 104, SANTA MARIA, CA 93454-5931
(805) 925-5334
(805) 922-5923
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ55899Z
BLUESHIELD
CA
Enumeration date
05/19/2006
Last updated
02/20/2020
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