Organization
CENTRAL COAST NEUROLOGY MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY S AMIR MD (PRESIDENT)
(805) 544-7511
Entity
Organization
Contact information
Practice address
1035 PEACH ST, SUITE 204, SAN LUIS OBISPO, CA 93401-2700
(805) 544-7511
(805) 544-7560
Mailing address
1035 PEACH ST, SUITE 204, SAN LUIS OBISPO, CA 93401-2700
(805) 544-7511
(805) 544-7560
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
Primary
G04937
CA
Other
Enumeration date
06/20/2014
Last updated
06/20/2014
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