Organization
COAST FAMILY PRACTICE
Active
Other names
Andrew J. Henning
Organization subpart
No
Provider details
NPI number
Authorized official
ROXANA MATA P.A-C (PHYSICIAN ASSISTANT)
(805) 928-3636
Entity
Organization
Contact information
Practice address
607 PLAZA DR, SUITE C201, SANTA MARIA, CA 93454-6944
(805) 928-3636
(805) 928-3608
Mailing address
607 E. PLAZA DRIVE, SUITE C201, SANTA MARIA, CA 93454-6944
(805) 928-3636
(805) 928-3608
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/18/2007
Last updated
08/22/2020
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