MARK C BOCCHICCHIO (NPI# 1770543373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770543373 |
| Entity Type | Individual |
| Full Name | MARK C BOCCHICCHIO |
| Credential | MD, FACC |
| Practice Address |
1941 Johnson Ave Ste 101 San Luis Obispo CA 93401-4154 |
| Mailing Address |
1941 Johnson Ave Suite 101 San Luis Obispo CA 93401-4140 |
| Practice Telephone | (805) 782-8844 |
| Practice Fax Number | 8057828859 |
| Mailing Telephone | (805) 782-8844 |
| Mailing Fax Number | 8057828859 |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
A63687 | CA | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
A63687 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A6368700 | 05 | |
| CA | BLUE SHIELD | ZZZ28458Z | 01 |
| CA | RR MEDI-CARE | P00187560 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1941 Johnson Ave Ste 102, San Luis Obispo, CA 934014174 | 8055405847 | 8055405827 |
| 310 S Halcyon Rd Ste 105, Arroyo Grande, CA 934203863 | 8057828844 | 8057828859 |
| Street Address |
1941 JOHNSON AVE STE 101 |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip Code | 93401-4154 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245645050 | Michael Doyle | Physician Assistant | 1941 Johnson Ave Ste 101, San Luis Obispo, CA 93401-4154 | 2014-07-01 |
| 1407122823 | Jennifer Anne Springer | Internal Medicine | 1941 Johnson Ave Ste 101, San Luis Obispo, CA 93401 | 2012-03-29 |
| 1689756256 | Maria G Sciammarella | Specialist | 1941 Johnson Ave Ste 101, San Luis Obispo, CA 93401-4154 | 2006-10-20 |
| 1720183569 | Coastal Cardiology A Medical Corp | Internal Medicine | 1941 Johnson Ave Ste 101, San Luis Obispo, CA 93401-4154 | 2006-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497228399 | Barbara Jean Morrow | Dental Hygienist | 2191 Johnson Avenue, San Luis Obispo, CA 93401 | 2019-01-03 |
| 1104307743 | Griffith Jennings | Counselor | 1225 Kendal Rd, San Luis Obispo, CA 93401 | 2018-08-22 |
| 1124518808 | Joy L Delaluna | Licensed Psychiatric Technician | 692 Evens Rd, San Luis Obispo, CA 93401 | 2018-05-17 |
| 1982192084 | Sierra Mental Wellness Group | Community/Behavioral Health | 2180 B Johnson Avenue, San Luis Obispo, CA 93401 | 2018-04-25 |
| 1326554403 | Veronica Chanel Laguna | Case Manager/Care Coordinator | 1065 Kansas Ave., San Luis Obispo, CA 93401 | 2017-12-27 |
| 1043739782 | Janette Lynn Branca | Case Manager/Care Coordinator | 285 South Street, Suit J, San Louis Obispo, CA 93401 | 2017-09-13 |
| 1588194104 | Adv Vision LLC | Optometrist | 835 Aero Vista Pl, #110, San Luis Obispo, CA 93401 | 2017-06-15 |
| 1508395880 | Samantha Clay | Counselor | 1255 Kendall Road, San Luis Obispo, CA 93401 | 2017-06-08 |
| 1659804771 | Sara Anne Powers | Counselor | 697 Higuera Street D, San Luis Obispo, CA 93401 | 2017-04-05 |
| 1508306010 | Russell Piazza | Pharmacist | 873 Ricardo Court, San Luis Obispo, CA 93401 | 2017-03-02 |
| Find all providers in zip 93401 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902961444 | Kenneth P. Tway, M.d., F.a.c.c., Inc. | Internal Medicine | 1106 Pacific St, San Luis Obispo, CA 93401-3302 | 2006-12-26 |
| 1629619192 | Joel Lardizabal, Md Inc | Internal Medicine | 35 Casa St Ste 340, San Luis Obispo, CA 93405-1894 | 2019-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104430412 | Anitha Rajamanickam Md Apmc | Internal Medicine | 3907 Waring Rd Ste 3, Oceanside, CA 92056-4454 | 2020-09-03 |
| 1316574890 | Woodland Hills Cardiology Group, PC | Internal Medicine | Woodland Hills Cardiology Group, PC, 22900 Ventura Blvd, Ste 165, Woodland Hills, CA 91364 | 2020-03-25 |
| 1841820677 | Sarsam Cardiology A Professional Corporation | Internal Medicine | 31285 Temecula Pkwy Ste 220, Temecula, CA 92592-6833 | 2020-01-21 |
| 1982246575 | Golden State Heart & Vascular Associates | Internal Medicine | 1850 El Camino Real Ste 200, Burlingame, CA 94010 | 2019-10-15 |
| 1861048613 | Sam Dawkins | Internal Medicine | Suite 415e, 8631 West Third Street, Los Angeles, CA 90048 | 2019-08-16 |
| 1336708494 | Peripheral Vascular Institute, Inc. A Podiatry Corp | Internal Medicine | 2100 Solar Dr Ste 103, Oxnard, CA 93036-0649 | 2019-06-11 |
| 1568020709 | Bakersfield Vascular Care Inc | Internal Medicine | 3550 Q St Ste 205, Bakersfield, CA 93301-1645 | 2019-06-03 |
| 1669974689 | Hossein Eftekhari Md Inc | Internal Medicine | 4147 Pascal Pl, Palos Verdes Peninsula, CA 90274-3941 | 2018-03-06 |
| 1104324102 | Adventist Health Physicians Network | Internal Medicine | 414 G St Ste 108, Marysville, CA 95901-5669 | 2018-01-25 |
| 1194223198 | Adventist Health Physicians Network | Internal Medicine | 414 G St Ste 210, Marysville, CA 95901-5669 | 2018-01-25 |
| Find all providers with the same taxonomy | ||||
| City | SAN LUIS OBISPO |
| Zip Code | 93401 |
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| 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.