Organization
CENTRAL COAST MOBILITY
Active
Other names
Mobility Masters
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALI TATREAU (MANAGER)
(805) 772-8210
Entity
Organization
Contact information
Practice address
358 QUINTANA RD, MORRO BAY, CA 93442-2054
(805) 772-8210
Mailing address
358 QUINTANA RD, MORRO BAY, CA 93442-2054
(805) 772-8210
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
097336
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
089322152
BLUE CROSS
CA
05
—
DME03097F
—
CA
Enumeration date
02/01/2010
Last updated
02/01/2010
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