Organization
PACIFIC CENTRAL COAST HEALTH CENTERS
Active
Parent organization
PACIFIC CENTRAL COAST HEALTH CENTERS
Other names
Coastal Valley Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PACIFIC CENTRAL COAST HEALTH CENTERS
Authorized official
MATTHEW RICHARDSON (CHIEF FINANCIAL OFFICER)
(805) 739-3108
Entity
Organization
Contact information
Practice address
1510 E MAIN ST, SUITE 104-C, SANTA MARIA, CA 93454-4825
(805) 349-8514
(805) 614-0223
Mailing address
117 W BUNNY AVE, SANTA MARIA, CA 93458-2805
(805) 349-8514
(805) 349-8958
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ06481Z
BSCA
—
Enumeration date
12/20/2011
Last updated
11/12/2018
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