Organization
CENTRAL COAST NEPHROLOGY MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BARBARA LOIS REVER MD (PRESIDENT)
(831) 755-7999
Entity
Organization
Contact information
Practice address
917 BLANCO CIRCLE, SALINAS, CA 93901-4446
(831) 755-7999
(831) 755-7975
Mailing address
917 BLANCO CIRCLE, SALINAS, CA 93901-4446
(831) 755-7999
(831) 755-7975
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
A116032
CA
207RN0300X
Nephrology Physician
Primary
A36123
CA
207RN0300X
Nephrology Physician
A66902
CA
207RN0300X
Nephrology Physician
A767040
CA
207RN0300X
Nephrology Physician
G308710
CA
207RN0300X
Nephrology Physician
G507670
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A361230
—
CA
05
—
00A669020
—
CA
05
—
00A767040
—
CA
05
—
00G308710
—
CA
05
—
00G507670
—
CA
01
—
ZZZ24103Z
MEDICARE PTAN ANNA MALKINA, MD
CA
Enumeration date
08/27/2006
Last updated
03/07/2023
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