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CENTRAL COAST NEUROLOGY MEDICAL GROUP INC NPI 1790199479


NPI Information

NPI: 1790199479
Provider Name: CENTRAL COAST NEUROLOGY MEDICAL GROUP, INC
Classification: Psychiatry & Neurology - 2084N0600X
Entity Type: Organization

Specialization: Clinical Neurophysiology

Address:
1035 PEACH ST
SUITE 204
SAN LUIS OBISPO, CA
ZIP 93401
Phone: (805) 544-7511
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CENTRAL COAST NEUROLOGY MEDICAL GROUP, INC is a clinical neurophysiology psychiatry neurology in San Luis Obispo, CA. The provider is clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS). CENTRAL COAST NEUROLOGY MEDICAL GROUP, INC NPI is 1790199479. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1035 PEACH ST
SUITE 204
SAN LUIS OBISPO, CA
ZIP 93401-700
Phone: (805) 544-7511
Fax: (805) 544-7560

The provider's authorized official is Mary S Amir .
The authorized official title is President and has the following contact phone number (805) 544-7511.

The enumeration date for this NPI number is 6/20/2014 and was last updated on 6/20/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084N0600XPsychiatry & NeurologyClinical NeurophysiologyG04937CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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