Organization
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST INC
Active
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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