Organization
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC
Active
Other names
Los Robles Comm Med Ctr
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD E CASTLE (CHIEF EXECUTIVE OFFICER)
(805) 929-3211
Entity
Organization
Contact information
Practice address
1105 LAS TABLAS RD, SUITE A, TEMPLETON, CA 93465-9731
(805) 434-9641
(805) 434-5925
Mailing address
150 TEJAS PL, PO BOX 430, NIPOMO, CA 93444-9123
(805) 929-3211
(805) 929-6440
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCP70812F
CANCER DETECTION PROGRAM
CA
05
—
FHC70812F
—
CA
01
—
HAP70812F
FAMILY PLANNING
CA
01
—
ZZZ54020Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
07/16/2006
Last updated
05/26/2010
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