Organization
CENTRAL COAST ORTHOPEDIC MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERI LYNN BROCKETT (PRACTICE MANAGER)
(805) 349-9545
Entity
Organization
Contact information
Practice address
862 MEINECKE AVE, SUITE 100, SAN LUIS OBISPO, CA 93405-1721
(805) 541-4600
(805) 541-3566
Mailing address
2342 PROFESSIONAL PKWY, SUITE 200, SANTA MARIA, CA 93455-1630
(805) 349-9545
(805) 349-9055
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
06/15/2006
Last updated
06/22/2010
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