Organization
ASSOCIATED ANESTHESIOLOGISTS OF THE CENTRAL COAST
Active
Organization
ASSOCIATED ANESTHESIOLOGISTS OF THE CENTRAL COAST
Active
Other names
COASTAL ANESTHESIOLOGY MEDICAL ASSOCIATES
Organization subpart
No
Provider details
NPI number
Authorized official
BOB HETZEL (MANAGER)
(805) 550-1074
Entity
Organization
Contact information
Practice address
1010 MURRAY ST, SAN LUIS OBISPO, CA 93405
(805) 928-1731
(805) 349-8160
Mailing address
PO BOX 6406, SANTA MARIA, CA 93456-6406
(805) 928-1731
(805) 349-8160
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0084310
—
CA
01
—
ZZZ57363Z
BLUE SHIELD GROUP PROVIDE
CA
Enumeration date
09/26/2005
Last updated
05/17/2018
Update your record
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