Organization
CENTRAL COAST URGENT CARE MEDICAL GROUP
Active
Other names
Central Coast Urgent Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS A CARUSO MD (PHYSICIAN PARTNER)
(805) 922-0561
Entity
Organization
Contact information
Practice address
340 EAST BETTERAVIA RD, SUITE C, SANTA MARIA, CA 93454-7847
(805) 922-0561
(805) 922-0083
Mailing address
PO BOX 848722, BOSTON, MA 02284-8722
(805) 922-0561
(805) 922-0083
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083643878
NPI
CA
01
—
1245327840
NPI
CA
01
—
1376510529
NPI
CA
01
—
1437246022
NPI
CA
01
—
1609965433
NPI
CA
01
—
1891840088
NPI
CA
01
—
W8259
MEDICARE GROUP ID
CA
01
—
WA50123B
MEDICARE PPIN
CA
01
—
WG32607A
MEDICARE PPIN
CA
01
—
WG48284A
MEDICARE PPIN
CA
01
—
WG61780E
MEDICARE PPIN
CA
01
—
WPT10965B
MEDICARE PPIN
CA
01
—
WPT8518A
MEDICARE PPIN
CA
01
—
ZZZ16208Z
BLUE SHIELD
CA
Enumeration date
01/25/2007
Last updated
06/17/2009
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