Organization
MIDCOAST CARDIOVASCULAR ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK L GINKEL MD (PRESIDENT)
(805) 354-0112
Entity
Organization
Contact information
Practice address
220 S PALISADE DR, SUITE # 101, SANTA MARIA, CA 93454-8902
(805) 354-0112
(805) 354-0234
Mailing address
220 S PALISADE DR, SUITE # 101, SANTA MARIA, CA 93454-8902
(805) 354-0112
(805) 354-0234
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
G71322
CA
207RI0011X
Interventional Cardiology Physician
Primary
G71322
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FM385A
MEDICARE PTAN
CA
01
—
ZZZ68791Y
BLUE SHIELD PIN
CA
Enumeration date
09/07/2011
Last updated
03/01/2016
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