Organization
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC
Active
Organization
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC
Active
Other names
Community Health Centers Coast Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD E CASTLE (CHIEF EXECUTIVE OFFICER)
(805) 929-3211
Entity
Organization
Contact information
Practice address
336 S HALCYON RD, ARROYO GRANDE, CA 93420-3898
(805) 489-3652
(805) 481-1017
Mailing address
150 TEJAS PL, PO BOX 430, NIPOMO, CA 93444-9123
(805) 929-3211
(805) 929-6440
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCP70593F
CANCER DETECTION PROGRAM
CA
05
—
FHC70593F
—
CA
01
—
HAP70593F
FAMILY PLANNING
CA
01
—
ZZZ52117Z
BLUE SHIELD
CA
Enumeration date
07/16/2006
Last updated
10/30/2012
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