Organization
CENTRAL COAST PEDIATRIC SURGICAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT C KANARD MD (OWNER)
(224) 420-0879
Entity
Organization
Contact information
Practice address
400 W PUEBLO ST, SANTA BARBARA, CA 93105-4353
(805) 879-4271
Mailing address
PO BOX 1359, SAN CLEMENTE, CA 92674-1359
(949) 492-3514
(949) 366-2390
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
2080P0203X
Pediatric Critical Care Medicine Physician
—
—
2086S0120X
Pediatric Surgery Physician
Primary
—
—
Other
Enumeration date
11/30/2017
Last updated
11/30/2017
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