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 J THEIS MD (PRESIDENT)
(805) 349-1227
Entity
Organization
Contact information
Practice address
915 E STOWELL RD STE B, SANTA MARIA, CA 93454-7010
(805) 938-7424
(805) 938-7422
Mailing address
915 E STOWELL RD, SUITE B, SANTA MARIA, CA 93454-7009
(805) 938-7424
(805) 938-7422
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ60013Z
BLUESHIELD
CA
Enumeration date
10/05/2007
Last updated
02/20/2020
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