Organization
CENTRAL COAST CHEST CONSULTANTS A MEDICAL CORPORATION
Active
Other names
Central Coast Chest Consultants Medical Corporation
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J RYAN MD (PRESIDENT)
(805) 543-4407
Entity
Organization
Contact information
Practice address
1428 PHILLIPS LN, SUITE 203, SAN LUIS OBISPO, CA 93401-2537
(805) 543-4407
(805) 543-4587
Mailing address
PO BOX 12460, SAN LUIS OBISPO, CA 93406-2460
(805) 548-1142
(805) 234-9985
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A62340
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
2070377
CA
207RP1001X
Pulmonary Disease Physician
2070377
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
184149800
US DOL PIN
—
05
—
GR0046460
—
CA
01
—
ZZZ13198Z
BLUE SHIELD TEMPLETON
CA
01
—
ZZZ138136Z
BLUE SHIELD PIN - FRENCH
CA
01
—
ZZZ138137Z
BLUE SHIELD PIN - SVRMC
CA
01
—
ZZZ25763Z
BLUE SHIELD PIN - PHILLIP
CA
Enumeration date
12/22/2005
Last updated
06/11/2024
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