Organization
CENTRAL COAST ENDOSCOPY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN G JOHNSON MD (DIRECTOR)
(831) 800-7887
Entity
Organization
Contact information
Practice address
243 GREEN VALLEY RD STE F, FREEDOM, CA 95019-3133
(831) 763-0407
(831) 763-0101
Mailing address
1081 LOS PALOS DR, SALINAS, CA 93901-3916
(831) 763-0407
(831) 763-0101
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051396- 001
BLUE CROSS PROVIDER #
CA
05
—
SUR01396F
—
CA
01
—
ZZZH4400Z
B/SHIELD PROVIDER #
CA
Enumeration date
06/09/2006
Last updated
02/07/2023
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