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Organization

COMMUNITY HEATLH CENTERS OF THE CENTRAL COAST

Active
Other names
CHC Pharmacy Atascadero
Organization subpart
No

Provider details

NPI number
Authorized official
DR. J CHRIS MITSUOKA PHARM.D. (DIRECTOR OF PHARMACY)
(805) 269-1326
Entity
Organization

Contact information

Practice address
5575 CAPISTRANO AVE, ATASCADERO, CA 93422-4264
(805) 792-1422
(805) 792-1488
Mailing address
150 TEJAS PL, NIPOMO, CA 93444-9123
(805) 269-1326
(805) 269-1388

Taxonomy

Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
PHY 46797
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5613612
NCPDP NUMBER
CA
05
PHA467970
CA
01
PHY46797
PHARMACY LICENSE #
CA
Enumeration date
10/19/2005
Last updated
03/07/2023
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