CENTRAL COAST VASCULAR, INC. (NPI# 1891855193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891855193 |
| Entity Type | Organization |
| Organization Name | CENTRAL COAST VASCULAR, INC. |
| Practice Address |
100 N Brent St Suite 201 Ventura CA 93003-2822 |
| Practice Telephone | 8056433300 |
| Practice Fax Number | 8056433331 |
| Mailing Telephone | 8056433300 |
| Mailing Fax Number | 8056433331 |
| Enumeration Date | 2006-12-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. CHRISTOPHER SHAWN SKILLERN (PRESIDENT) |
| Authorized Official Telephone | 8056433330 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | CENTRAL COAST VASCULAR, INC. | 100 N Brent Street St 201, Ventura, CA 93003 |
| Street Address |
100 N BRENT ST SUITE 201 |
| City | VENTURA |
| State | CA |
| Zip Code | 93003-2822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891764775 | Li Sheng Kong | Specialist | 100 N Brent St, Suite 201, Ventura, CA 93003-2822 | 2006-03-14 |
| 1144694720 | Ventura Asc LLC | Clinic/Center | 100 N Brent St, Suite 201, Ventura, CA 93003-2822 | 2015-11-19 |
| 1386030815 | Rao Cardiac Arrhythmia Inc | Internal Medicine | 100 N Brent St, Suite 103, Ventura, CA 93003-2822 | 2015-04-10 |
| 1174928329 | West Coast Vascular | Surgery | 100 N Brent St, Suite 201, Ventura, CA 93003-2822 | 2014-10-30 |
| 1982862322 | John Pang | Internal Medicine | 100 N Brent St, #301, Ventura, CA 93003-2822 | 2008-05-31 |
| 1063619245 | Todd Anderson Md Inc. | Orthopaedic Surgery | 100 N Brent St, Suite 203, Ventura, CA 93003-2822 | 2007-06-29 |
| 1841316429 | Michael D Rosco | Legal Medicine | 100 N Brent St, Suite 100, Ventura, CA 93003-2822 | 2007-03-22 |
| 1154425320 | Newton J. Friedman | Internal Medicine | 100 N Brent St, Ste 301, Ventura, CA 93003 | 2006-09-11 |
| 1063516235 | Craig S Mansour | Internal Medicine | 100 N Brent St, Ste 301, Ventura, CA 93003 | 2006-09-11 |
| 1972607141 | Ventura Cardiology Consultants Medical Group, Inc. | Internal Medicine | 100 N Brent St, Ste 301, Ventura, CA 93003 | 2006-09-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124645924 | Community Memorial Health System | Pharmacy | 2790 Loma Vista Road, Ventura, CA 93003 | 2020-06-29 |
| 1730702952 | Sarah Manon Begert | Student in an Organized Health Care Education/Training Program | 300 Hillmont Ave., Bldg 340, Ste 201, Ventura, CA 93003 | 2020-05-21 |
| 1033763677 | Ashley Danielle Aguilar | Counselor | 5740 Ralston Suite 100, Ventura, CA 93003 | 2019-08-01 |
| 1730747239 | Azadeh Ellsworth | Nurse Practitioner | 1752 S Victoria Ave Ste 250, Ventura, CA 93003 | 2019-05-31 |
| 1992275556 | Melissa Marie Cole | Social Worker | 4949 Market St, Ventura, CA 93003 | 2018-11-27 |
| 1851868400 | Weldon Acupuncture Professional Corporation | Acupuncturist | 3737 Telegraph Road, Suite F, Ventura, CA 93003 | 2018-10-31 |
| 1952876468 | Isabella Florencia Gallegos | Specialist/Technologist | 1857 Knoll Dr., Ventura, CA 93003 | 2018-10-11 |
| 1437645421 | Jill Huang Wong | Psychologist | 3585 Maple St Ste 248, Ventura, CA 93003 | 2018-07-02 |
| 1346735156 | Lisa Ngoc Thi Nguyen | Student in an Organized Health Care Education/Training Program | 147 N. Brent Street, Ventura, CA 93003 | 2018-06-25 |
| 1457845331 | Khloe Frank | Student in an Organized Health Care Education/Training Program | 300 Hillmont Ave, Bldg 340, Suite 201, Ventura, CA 93003 | 2018-06-14 |
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| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053575548 | West Coast Vascular | Surgery | 100 N Brent St Ste 201, Ventura, CA 93003-2835 | 2008-07-14 |
| 1114561305 | Css Enterprises, Inc. | Surgery | 3555 Loma Vista Rd Ste 100, Ventura, CA 93003-3161 | 2019-10-31 |
| 1174928329 | West Coast Vascular | Surgery | 100 N Brent St, Suite 201, Ventura, CA 93003-2822 | 2014-10-30 |
| 1750607453 | John Tyler Baber Jr. | Surgery | 100 N Brent St Ste 201, Ventura, CA 93003-2835 | 2010-04-20 |
| 1740414606 | Sara Jean Runge | Surgery | 100 N Brent St Ste 201, Ventura, CA 93003-2835 | 2009-05-07 |
| 1295800308 | California Cardiovascular and Thoracic Surgeons | Surgery | 168 N Brent St, Suite 508, Ventura, CA 93003-2817 | 2006-11-22 |
| 1205936697 | Christopher Shawn Skillern | Surgery | 3555 Loma Vista Rd Ste 100, Ventura, CA 93003-3161 | 2006-09-25 |
| 1033219423 | California Cardiac Surgeons - A Medical Group | Surgery | 145 N Brent St, Suite 102, Ventura, CA 93003-2816 | 2006-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881213817 | Robert Morton Carroll X | Surgery | 2241 Century Hl, Los Angeles, CA 90067-3506 | 2020-04-09 |
| 1992341895 | Surgicalist of Ca PC | Surgery | 3300 E South St Ste 301a, Lakewood, CA 90805-4549 | 2019-11-26 |
| 1528600558 | Kevin M Casey Md Apmc | Surgery | 1919 State St # 204-206, Santa Barbara, CA 93101-2430 | 2019-10-10 |
| 1487117594 | John Nastasi | Surgery | 100 W Valencia Mesa Dr # 211, Fullerton, CA 92835-3768 | 2019-04-08 |
| 1225508385 | Jay Labourene | Surgery | 1550 G Tiburon Blvd, Tiburon, CA 94920-2531 | 2018-12-03 |
| 1467922120 | Paul Bressman Md Inc | Surgery | 1493 S Crest Dr, Los Angeles, CA 90035-3339 | 2018-11-26 |
| 1437638517 | Thousand Oaks Vein Clinic PC | Surgery | 225 N Moorpark Rd Ste C, Thousand Oaks, CA 91360-4320 | 2018-08-09 |
| 1881186377 | Lavs Access Center Inc. | Surgery | 620 W Beverly Blvd Ste B, Montebello, CA 90640-3624 | 2018-05-31 |
| 1841789328 | Sunil Rayan, M.d., Inc. | Surgery | 320 Santa Fe Dr Ste 212, Encinitas, CA 92024-5139 | 2018-05-09 |
| 1245739820 | Northridge Vascular Center A Professional Medical Corporation | Surgery | 19331 Business Center Dr Ste 102, Northridge, CA 91324-3533 | 2018-02-08 |
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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.