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CENTRAL COAST PAIN MANAGEMENT SPECIALISTS INC. NPI 1245841394


NPI Information

NPI: 1245841394
Provider Name: CENTRAL COAST PAIN MANAGEMENT SPECIALISTS, INC.
Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 05D2203162

Address:
10 SANTA ROSA ST STE 201
SAN LUIS OBISPO, CA
ZIP 93405
Phone: (805) 597-8314
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CENTRAL COAST PAIN MANAGEMENT SPECIALISTS, INC. is a specialist in San Luis Obispo, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. CENTRAL COAST PAIN MANAGEMENT SPECIALISTS, INC. NPI is 1245841394. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

10 SANTA ROSA ST STE 201
SAN LUIS OBISPO, CA
ZIP 93405-826
Phone: (805) 597-8314
Fax: (805) 597-8350

The provider's authorized official is Carlos Untal .
The authorized official title is President and has the following contact phone number (805) 597-8314.

The CLIA number assigned to this NPI record is 05D2203162 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/12/2020 and was last updated on 8/19/2020.


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
1174400000XSpecialistYes

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: 4/28/2024

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