Organization
CENTRAL COAST PATHOLOGY CONSULTANTS, INC
Active
Other names
CCPC Clinical Lab
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD E ROCHA M.D. (PRESIDENT/PATHOLOGIST)
(805) 541-6033
Entity
Organization
Contact information
Practice address
3701 S HIGUERA ST, STE. 200, SAN LUIS OBISPO, CA 93401-7462
(805) 541-6033
(805) 541-6116
Mailing address
PO BOX 8139, SAN LUIS OBISPO, CA 93403-8139
(805) 549-7461
(805) 549-7463
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0058760
—
CA
05
—
LAB43503F
—
CA
Enumeration date
03/21/2006
Last updated
12/09/2010
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