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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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