Organization
CENTRAL COAST EAR NOSE AND THROAT ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM J. WATSON M.D. (OWNER)
(805) 545-5665
Entity
Organization
Contact information
Practice address
1035 PEACH ST, SUITE 301, SAN LUIS OBISPO, CA 93401-2700
(805) 545-5665
(805) 544-6477
Mailing address
PO BOX 13211, SAN LUIS OBISPO, CA 93406-3211
(805) 545-5665
(805) 544-6477
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
G42368
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4306521
AETNA PIN
CA
05
—
GROO46750
—
CA
01
—
ZZZ25994Z
BLUE SHIELD PIN
CA
Enumeration date
09/22/2006
Last updated
11/28/2007
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