PACIFIC CENTRAL COAST HEALTH CENTERS (NPI# 1356755789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356755789 |
| Entity Type | Organization |
| Organization Name | PACIFIC CENTRAL COAST HEALTH CENTERS |
| Other Organization Name | MEDICAL CLINIC AT CASA |
| Practice Address |
100 Casa St Suite B San Luis Obispo CA 93405-1883 |
| Mailing Address |
117 W Bunny Ave Santa Maria CA 93458-2805 |
| Practice Telephone | 8055448811 |
| Practice Fax Number | 8505448997 |
| Mailing Telephone | 8057393898 |
| Mailing Fax Number | 8056145932 |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2018-11-12 |
| Authorized Official Name | MATTHEW RICHARDSON (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 8057393108 |
| Is Organization Subpart | Y |
| Parent Organization Name | PACIFIC CENTRAL COAST HEALTH CENTERS |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IRS | ========= | 01 |
| Other Name | Type Code |
|---|---|
| Medical Clinic at Casa | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555061 | Pacific Central Coast Health Centers | Clinic/Center | 1560 Mesa Rd, Ste 101, Nipomo, CA 93444 | 2020-10-15 |
| 1841829876 | Pacific Central Coast Health Centers | Clinic/Center | 1992 Old Mission Dr Ste 140, Solvang, CA 93463-2302 | 2020-04-02 |
| 1396387569 | Pacific Central Coast Health Centers | Clinic/Center | 3807 Union Ave # B, Bakersfield, CA 93305-2400 | 2019-10-09 |
| 1861965055 | Pacific Central Coast Health Centers | Clinic/Center | 850 Fair Oaks Ave Ste 310, Arroyo Grande, CA 93420 | 2019-01-10 |
| 1023523990 | Pacific Central Coast Health Centers | Clinic/Center | 2271 S Depot St, Santa Maria, CA 93455-1216 | 2017-12-13 |
| 1306225941 | Pacific Central Coast Health Centers | Clinic/Center | 1102 E Clark Ave, Suite 120a, Santa Maria, CA 93455-5174 | 2015-05-28 |
| 1598002537 | Pacific Central Coast Health Centers | Clinic/Center | 689 Tank Farm Rd Ste 220, San Luis Obispo, CA 93401-7079 | 2013-01-10 |
| 1063496651 | Pacific Central Coast Health Centers | Clinic/Center | 117 W Bunny Ave, Santa Maria, CA 93458-2805 | 2005-12-06 |
| 1356949291 | Pacific Central Coast Health Centers | Clinic/Center | 3418 Loma Vista Rd Ste B, Ventura, CA 93003-3065 | 2020-10-13 |
| 1821610239 | Pacific Central Coast Health Centers | Clinic/Center | 1300 E Cypress St Ste B1, Santa Maria, CA 93454-4730 | 2020-05-08 |
| Street Address |
100 CASA ST SUITE B |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip Code | 93405-1883 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790787141 | Jonathan R Stella | Radiology | 100 Casa St, Suite C, San Luis Obispo, CA 93405-1883 | 2005-08-15 |
| 1972821601 | Lauren Marie Tait | Radiology | 100 Casa St, Suite C, San Luis Obispo, CA 93405-1883 | 2010-05-05 |
| 1376556217 | Central Coast Obstetrics and Gynecology, Inc., A Medical Group | Obstetrics & Gynecology | 100 Casa St, Suite B, San Luis Obispo, CA 93405-1883 | 2006-08-14 |
| 1235150921 | Melody Kopisch | Nurse Practitioner | 100 Casa St, Suite B, San Luis Obispo, CA 93405-1883 | 2006-07-21 |
| 1720004237 | Barbara Lynne Clutter | Obstetrics & Gynecology | 100 Casa St, Suite B, San Luis Obispo, CA 93405-1883 | 2006-07-15 |
| 1730111931 | Coastal Radiation Oncology Medical Group, Inc. | Radiology | 100 Casa St, Suite C, San Luis Obispo, CA 93405-1883 | 2006-07-07 |
| 1922038173 | Coastal Radiation Oncology Medical Group, Inc. | Radiology | 100 Casa St, Suite C, San Luis Obispo, CA 93405-1883 | 2006-07-04 |
| 1821078692 | Leonard A. Cedars | Obstetrics & Gynecology | 100 Casa St, Suite D-3, San Luis Obispo, CA 93405-1883 | 2006-01-18 |
| 1649250424 | Nihal Naccasha | Obstetrics & Gynecology | 100 Casa St, Suite D-3, San Luis Obispo, CA 93405-1883 | 2006-01-18 |
| 1639159411 | Central Coast Maternal-fetal Medicine | Obstetrics & Gynecology | 100 Casa St, Suite D-3, San Luis Obispo, CA 93405-1883 | 2006-01-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164076626 | Hilary Abbott Anderson | Physician Assistant | 127 Casa St., San Luis Obispo, CA 93405 | 2019-08-01 |
| 1811465834 | Fatemeh Ladan Ahmadinia | Dentist | 764 N Santa Rosa St, San Luis Obispo, CA 93405 | 2018-11-07 |
| 1538559794 | Arnold Martin Horwitz | Marriage & Family Therapist | 1605 Garnette Drive, San Luis Obispo, CA 93405 | 2015-01-27 |
| 1750794764 | Solmaz Naghsh | Pharmacist | 765 Foothill Blvd, San Luis Obispo, CA 93405 | 2014-06-06 |
| 1609293471 | Robert S. Flores Dmd, Inc | Dentist | 878 Boysen Avenue, San Luis Obispo, CA 93405 | 2014-03-18 |
| 1457776445 | Laura Anne Wilvert | Marriage & Family Therapist | 793 E. Foothill Blvd, Suite A, #278, San Luis Obispo, CA 93405 | 2014-02-27 |
| 1497181200 | Tracey Ruby Madrigal | Counselor | 1106 Oceanaire Dr. #25, San Luis Obispo, CA 93405 | 2013-09-25 |
| 1437597572 | Sarah Michelle Brenis | Counselor | 524 Princeton Place, San Luis Obispo, CA 93405 | 2013-06-11 |
| 1013350974 | Jenna Rose Ramos | Counselor | 1459 Descanso St., San Luis Obispo, CA 93405 | 2013-04-10 |
| 1700140696 | Christopher Dieterich Marchand | Social Worker | 793a E. Foothill Blvd, 190, San Luis Obispo, CA 93405 | 2012-06-26 |
| Find all providers in zip 93405 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598002537 | Pacific Central Coast Health Centers | Clinic/Center | 689 Tank Farm Rd Ste 220, San Luis Obispo, CA 93401-7079 | 2013-01-10 |
| 1700803285 | Planned Parenthood California Central Coast | Clinic/Center | 743 Pismo Street, San Luis Obispo, CA 93401 | 2006-07-17 |
| 1497392377 | Pacific Central Coast Health Centers | Clinic/Center | 1551 Bishop St Ste 230, San Luis Obispo, CA 93401-4661 | 2019-12-10 |
| 1417594391 | Pacific Central Coast Health Centers | Clinic/Center | 1551 Bishop St Ste 510, San Luis Obispo, CA 93401-4665 | 2019-12-10 |
| 1588225353 | Pacific Central Coast Health Centers | Clinic/Center | 4460 Broad St Ste A, San Luis Obispo, CA 93401-7933 | 2019-06-24 |
| 1689024259 | Pacific Central Coast Health Centers | Clinic/Center | 1941 Johnson Ave, Suite 105b, San Luis Obispo, CA 93401-4140 | 2016-06-15 |
| 1457741837 | Pacific Central Coast Health Centers | Clinic/Center | 1304 Ella St, Suite A, San Luis Obispo, CA 93401-4100 | 2015-01-23 |
| 1093105470 | Pacific Central Coast Health Centers | Clinic/Center | 1555 Higuera St, San Luis Obispo, CA 93401-2917 | 2015-01-23 |
| 1184014565 | Pacific Central Coast Health Centers | Clinic/Center | 1250 Peach St, Suite A, San Luis Obispo, CA 93401-2837 | 2015-01-23 |
| 1053700641 | Pacific Central Coast Health Centers | Clinic/Center | 171 N Santa Rosa St, San Luis Obispo, CA 93405-1328 | 2015-01-20 |
| Find all providers in SAN LUIS OBISPO | ||||
| City | SAN LUIS OBISPO |
| Zip Code | 93405 |
Please comment or provide details below to improve the information on PACIFIC CENTRAL COAST HEALTH CENTERS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.